title: First successful complete replantation of a traumatic hemipelvectomy: follow-up after 30 months.
abstract: Traumatic hemipelvectomy is a severe, however rare injury associated with high lethality. Up to now, immediate surgical completion of the amputation has been recommended as a lifesaving therapy. We present a case of near complete hemipelvectomy with open fracture of the ileosacral joint, wide open symphysis and severe soft tissue trauma including a decollement around the pelvis. Successful complete replantation was performed by primary internal stabilisation and revascularisation using vascular grafts. In the further hospital course, numerous revisions of the soft tissue injury and reconstructive surgery were needed. Thirty months later, the patient's condition is physically and psychologically stable and he is able to walk using crutches. The key point of successful management was skilled emergency damage control surgery followed by dedicated surgical care to avoid septic complications.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. walcher@trauma.uni-frankfurt.de
authors.forename: Felix
authors.initials: F
authors.lastname: Walcher
authors.forename: Thomas
authors.initials: T
authors.lastname: Lustenberger
authors.forename: Thomas
authors.initials: T
authors.lastname: Schmandra
authors.forename: Christian
authors.initials: C
authors.lastname: Byhahn
authors.forename: Helmut
authors.initials: H
authors.lastname: Laurer
authors.forename: Tobias
authors.initials: T
authors.lastname: Bingold
authors.forename: Uwe
authors.initials: U
authors.lastname: Schweigkofler
authors.forename: Benedikt
authors.initials: B
authors.lastname: Winckler
authors.forename: Gerhard
authors.initials: G
authors.lastname: Walter
authors.forename: Ingo
authors.initials: I
authors.lastname: Marzi
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005500:Follow-Up Studies; D005597:Fractures, Open / Q000601:surgery; D005858:Germany / Q000453:epidemiology; D006428:Hemipelvectomy; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012092:Replantation; D017695:Soft Tissue Injuries / Q000601:surgery
keywords: Replantation; Traumatic hemipelvectomy; Traumatic hindquarter amputation