Subscribe to RSS
DOI: 10.1055/s-0040-1703096
Pediatric Replantation after Traumatic Amputation at the Distal Forearm: Rehabilitation Protocol and Outcomes
![](https://www.thieme-connect.de/media/10.1055-s-00031417/202103/lookinside/thumbnails/10.1055-s-0040-1703096-1.jpg)
Abstract
Major limb replantation is a formidable task, especially in the pediatric setting. While meticulous microsurgical technique is required in the operating room, the authors aim to highlight the importance of postoperative rehabilitation therapy for optimal function. We highlight the case of a 12-year-old boy who suffered complete traumatic amputation through the distal left forearm. The limb was successfully replanted with successful restoration of sensation and function with the aid of intensive postoperative occupational therapy. A multidisciplinary team is of paramount importance to maximize function of a replanted upper extremity.
Publication History
Article published online:
13 April 2020
© 2020. Society of Indian Hand & Microsurgeons. All rights reserved. Thieme Medical and Scientific Publishers Pvt. Ltd., A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 Malt RA, McKhann C. Replantation of severed arms. JAMA 1964; 189 (10) 716-722
- 2 Friedrich JB, Poppler LH, Mack CD, Rivara FP, Levin LS, Klein MB. Epidemiology of upper extremity replantation surgery in the United States. J Hand Surg Am 2011; 36 (11) 1835-1840
- 3 Graham B, Adkins P, Tsai TM, Firrell J, Breidenbach WC. Major replantation versus revision amputation and prosthetic fitting in the upper extremity: a late functional outcomes study. J Hand Surg Am 1998; 23 (05) 783-791
- 4 Hudson DA, Bolitho DG, Hodgetts K. Primary epineural repair of the median nerve in children. J Hand Surg [Br] 1997; 22 (01) 54-56
- 5 Squitieri L, Reichert H, Kim HM, Steggerda J, Chung KC. Patterns of surgical care and health disparities of treating pediatric finger amputation injuries in the United States. J Am Coll Surg 2011; 213 (04) 475-485
- 6 Hostetler SG, Schwartz L, Shields BJ, Xiang H, Smith GA. Characteristics of pediatric traumatic amputations treated in hospital emergency departments: United States, 1990-2002. Pediatrics 2005; 116 (05) e667-e674
- 7 Beris AE, Soucacos PN, Malizos KN, Mitsionis GJ, Soucacos PK. Major limb replantation in children. Microsurgery 1994; 15 (07) 474-478
- 8 Abzug JM, Kozin SH. Pediatric replantation. J Hand Surg Am 2014; 39 (01) 143-145
- 9 O’Brien BM. Replantation surgery. Clin Plast Surg 1974; 1 (03) 405-426
- 10 Wilhelmi BJ, Lee WPA, Pagenstert GI, May Jr JW, May JW. Replantation in the mutilated hand. Hand Clin 2003; 19 (01) 89-120
- 11 Russell RC, O’Brien BM, Morrison WA, Pamamull G, MacLeod A. The late functional results of upper limb revascularization and replantation. J Hand Surg Am 1984; 9 (05) 623-633
- 12 Halikis MN, Manske PR, Kubota H, Aoki M. Effect of immobilization, immediate mobilization, and delayed mobilization on the resistance to digital flexion using a tendon injury model. J Hand Surg Am 1997; 22 (03) 464-472
- 13 Zhao H-W, Zhou C-X, Su X-L, Xiao X-C, Guo Y. Effect of mental intervention on post-stroke depression and rehabilitation of neurological function. Zhongguo Linchuang Kangfu 2004; 8 (13) 2408-2409
- 14 Ross DC, Manktelow RT, Wells MT, Boyd JB. Tendon function after replantation: prognostic factors and strategies to enhance total active motion. Ann Plast Surg 2003; 51 (02) 141-146
- 15 Michlovitz SL. Is there a role for ultrasound and electrical stimulation following injury to tendon and nerve?. J Hand Ther 2005; 18 (02) 292-296
- 16 Gordon T, Brushart TM, Amirjani N, Chan KM. The potential of electrical stimulation to promote functional recovery after peripheral nerve injury–comparisons between rats and humans. In: Millesi H, Schmidhammer R, eds. How to Improve the Results of Peripheral Nerve Surgery. Acta Neurochirurgica: Supplement 100. Vienna, Austria:. Springer-Verlag 2007; 3-11
- 17 Bindra RR, Brininger TL. American Society for Surgery of the Hand; American Society of Hand Therapists. Advanced Concepts Of Hand Pathology and Surgery: Application to Hand Therapy Practice. Rosemont, IL: American Society for Surgery of the Hand; 2010
- 18 Sturm SM, Oxley SB, Van Zant RS. Rehabilitation of a patient following hand replantation after near-complete distal forearm amputation. J Hand Ther 2014; 27 (03) 217-223