RT Journal
A1 Tintle, LT Scott M.
A1 Baechler, LTC Martin F.
A1 Nanos III, CDR George P.
A1 Forsberg, LCDR Jonathan A.
A1 Potter, MAJ Benjamin K.
T1 Traumatic and Trauma-Related AmputationsPart II: Upper Extremity and Future Directions
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2010
FD December 15
VO 92
IS 18
SP 2934
OP 2945
DO 10.2106/JBJS.J.00258
UL http://dx.doi.org/10.2106/JBJS.J.00258
AB Trauma is the most common reason for amputation of the upper extremity.The morphologic and functional distinctions between the upper and lower extremities render the surgical techniques and decision-making different in many key respects.Acceptance of the prosthesis and the outcomes are improved by performing a transradial rather than a more proximal amputation. Substantial efforts, including free tissue transfers when necessary, should be made to salvage the elbow.Careful management of the peripheral nerves is critical to minimize painful neuroma formation while preserving options for possible future utilization in targeted muscle reinnervation and use of a myoelectric prosthesis.Rapid developments with targeted muscle reinnervation, myoelectric prostheses, and composite tissue allotransplantation may dramatically alter surgical treatment algorithms in the near future for patients with severe upper-extremity trauma.