Traumatic forequarter amputations are rare injuries in which the arm, clavicle, scapula,
and proximal shoulder muscles are avulsed from the body. Historically, forequarter
amputation has been treated with hemorrhage control, wound debridement, and soft tissue
coverage. To our knowledge, successful forequarter replantation has not been previously
reported. We present a rare case of forequarter amputation treated successfully with
replantation. At the 4.5-year follow-up after replantation, the patient had antigravity
elbow flexion, modest shoulder elevation, modest extrinsic finger function, and crude
sensation. We discuss relevant technical considerations that indicate that, despite
challenges, forequarter replantation can be achieved with success.
Key words
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References
- Traumatic forequarter amputation.J Trauma. 1981; 21: 411-412
- Forequarter replantation and the lessons learnt.Plast Reconstr Surg Glob Open. 2015; 3: e509
- “On arrival block”-management of upper extremity trauma with resuscitation in the operating room.Plast Reconstr Surg Glob Open. 2020; 8e3191
- Major replantation.in: Boyd B. Jones N.F. Operative Microsurgery. McGraw Hill, 2015: 698-719
- Technical considerations and functional outcome of 22 major replantations (The BSSH Douglas Lamb Lecture, 2005).J Hand Surg Eur Vol. 2007; 32: 488-501
- Clinical factors associated with replantation after traumatic major upper extremity amputation.Plast Reconstr Surg. 2013; 132: 911-919
- Long-term outcomes of arm replantation.Ann Plast Surg. 2020; 84: S151-S157
- Replantation versus prosthetic fitting in traumatic arm amputations: a systematic review.PLoS One. 2015; 10e0137729
- Comparison of patient-reported outcomes after traumatic upper extremity amputation: replantation versus prosthetic rehabilitation.Injury. 2016; 47: 2783-2788
- Forequarter amputation for high-grade malignant tumours of the shoulder girdle.J Bone Joint Surg Br. 1997; 79: 924-926
Article info
Publication history
Published online: September 21, 2021
Footnotes
Received for publication November 6, 2020; accepted in revised form July 16, 2021.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
