title: [Cross-hand replantation in bilateral upper limb amputation: An anatomical emergency].
abstract: Bilateral amputations of upper limbs are excessively rare clinical situations. We report an exceptional clinical case of bilateral amputation of upper limbs at different levels: destruction of the right hand and left transhumeral amputation in a patient after an attempted suicide on train lines. This special situation led us to perform a cross-hand replantation of the left hand to the right forearm. Only 4 other similar cases have been published in the literature. Once the surgical indication had been formulated collectively, and taking into account all the ethical issues surrounding such a decision, we had to solve the issue of inverting anatomical structures in emergency. We have provided a detailed description of our surgical technique. The aim was to save at least one organ used for grasping. The result obtained is presented and reviewed.
authors.affiliation: Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France; Laboratoire d'anatomie, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France. Electronic address: andre.a@chu-toulouse.fr.
authors.forename: A
authors.initials: A
authors.lastname: Andre
authors.affiliation: Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France; Laboratoire d'anatomie, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Rongieres
authors.affiliation: Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Laffosse
authors.affiliation: Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Pailhe
authors.affiliation: Laboratoire d'anatomie, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
authors.forename: F
authors.initials: F
authors.lastname: Lauwers
authors.affiliation: Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Grolleau
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005260:Female; D006225:Hand / Q000601:surgery*; D006801:Humans; D012092:Replantation / Q000379:methods*; D013406:Suicide, Attempted; D034941:Upper Extremity / Q000293:injuries / Q000601:surgery*
keywords: Amputation membre supérieur; Anatomie; Anatomy; Cross-over replantation; Emergency; Hand; Main; Réimplantation croisée; Upper limb amputation; Urgence