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Strategies in Trauma and Limb Reconstruction

, Volume 10, Issue 3, pp 189–193

First Online: 12 November 2015Received: 18 August 2013Accepted: 05 July 2015

Abstract

Replantation of an amputated limb is generally contraindicated in crushing and traction injuries. Injury to muscle tissue and skin also creates difficulties in coverage, and bony fractures may shorten limb length which can impede lower extremity function. Numerous cases have been reported on the successful replantation of the lower limb in children; however, review of previous English literature has documented only very few replantation at the thigh level, and those with severe crushing injury resulted in subsequent amputation. We report a case of successful thigh-level replantation in a 3-year-old child who sustained a crushing–traction type of injury with a follow-up of 24 years. After the replantation, early and late complications developed but these were successfully managed. On her last visit, the patient had pain-free ambulation without assistance, had intact protective sensation distal to the injury, and was very satisfied with the outcome. Replantation of the lower limb in children with crushing or avulsion type of injuries is still a worthwhile procedure. However, both the patient and the family should be aware that multiple surgeries may be needed to accommodate to long-term complications such as joint stiffness, scar contractures, and limb length discrepancies.

KeywordsLower limb Lower limb replantation Above-knee amputation Replantation in children  Download fulltext PDF



Autor: Claire Marie C. Durban - Seung-Yup Lee - Hong-Chul Lim

Fuente: https://link.springer.com/







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