H Piza-Katzer1, T Bauer, R Biedermann, D Estermann. 1. Klinik für Plastische- und Wiederherstellungschirurgie, Medizinische Universität Insbruck, Ludwig-Boltzmann-Institut für Qualitätssicherung in der Plastischen- und Wiederherstellungschirurgie, Innsbruck, Austria. hildegunde.piza@uibk.ac.at
Abstract
BACKGROUND: In a 28-year-old male who had suffered an olecranon fracture, delayed diagnosis was made of epithelioid sarcoma in the left upper extremity. Radical tumor resection was carried out which included removal of the entire elbow joint. MATERIAL AND METHODS: The amputated hand with the distal one-third of the forearm was replanted at the upper arm. It was important to ensure that all tendinous structures of the forearm were attached to the three muscles of the upper arm and the nerves of the distal forearm with the nerves of the upper arm, which are incongruent in diameter with the former. Details of the operation are given below. RESULTS: The anatomic peculiarities involved in this form of replantation, the early intensive therapy, reintegration of the replanted hand in the body scheme, and the usability of such a shortened extremity are described and the extremely good functional results documented in numbers and figures.
BACKGROUND: In a 28-year-old male who had suffered an olecranon fracture, delayed diagnosis was made of epithelioid sarcoma in the left upper extremity. Radical tumor resection was carried out which included removal of the entire elbow joint. MATERIAL AND METHODS: The amputated hand with the distal one-third of the forearm was replanted at the upper arm. It was important to ensure that all tendinous structures of the forearm were attached to the three muscles of the upper arm and the nerves of the distal forearm with the nerves of the upper arm, which are incongruent in diameter with the former. Details of the operation are given below. RESULTS: The anatomic peculiarities involved in this form of replantation, the early intensive therapy, reintegration of the replanted hand in the body scheme, and the usability of such a shortened extremity are described and the extremely good functional results documented in numbers and figures.