Download PDF
J Reconstr Microsurg 2003; 19(2): 087-092
DOI: 10.1055/s-2003-37812
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1 (212) 584-4662

Successful Replantation of an Amputated Leg with Severe Crush and Avulsion Injury in an Elderly Patient: Case Report

Gan Muneuchi1 , Shigehiko Suzuki1 , Osamu Ito1 , Masato Kurokawa2
  • 1Kagawa Medical University, Kagawa, Japan
  • 2Nagahama Red Cross Hospital, Shiga, Japan
Further Information

Publication History

Publication Date:
10 March 2003 (online)

    Permissions and Reprints

ABSTRACT

An amputated leg with severe crush and avulsion injury was replanted in a 57-year-old man. Since the skin and soft tissue around the ankle became necrotic 11 days postoperatively, a flow-through forearm free flap was transferred into the defect, preserving the blood circulation to the replanted leg. Seven weeks after the replantation, sural nerve cable grafts were interposed between both amputated edges of the tibial nerve. As the function of the ankle joint did not recover, arthrodesis of the ankle joint was performed 7 months after the replantaion. As a result, the patient could walk 1 year postoperatively.

KEYWORDS

Lower limb replantation - crush and avulsion amputation - elderly patient

REFERENCES

  • 1 Malt R A, McKhan C F. Replantation of severed arms.  JAMA . 1964;  189 716
    CrossrefPubMedGoogle Scholar
  • 2 McDowell F. Get in there and replant.  Plast Reconstr Surg . 1973;  52 562-567
    PubMedGoogle Scholar
  • 3 O'Brien B M. Replantation surgery in China.  Med J Australia . 1974;  2 255-259
    PubMedGoogle Scholar
  • 4 Roth R B. Replantation in China.  JAMA . 1974;  230 1127-1128
    CrossrefPubMedGoogle Scholar
  • 5 Magee H R, Parker W R. Replantation of the foot: results after two years.  Med J Australia . 1972;  1 751-755
    PubMedGoogle Scholar
  • 6 Chen Z W, Zeng B F. Replantation of the lower extremity.  Clin Plast Surg . 1983;  10 103-113
    PubMedGoogle Scholar
  • 7 Fukui A, Tamai S. Present status of replantation in Japan.  Microsurgery . 1994;  15 842-847
    CrossrefPubMedGoogle Scholar
  • 8 Fukui A, Inada Y, Sempuku T, Tamai S. Successful replantation of the foot with satisfactory recovery: a case report.  J Reconstr Microsurg . 1988;  4 387-390
    PubMedGoogle Scholar
  • 9 Datiashvili R O, Chichkin V G. Successful replantation of the lower leg after 42-hour ischemia: case report.  J Reconstr Microsurg . 1992;  8 447-453
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Kutz J E, Jupiter J B. Lower limb replantation, a report of nine cases.  Foot Ankle . 1983;  3 197-202
    CrossrefPubMedGoogle Scholar
  • 11 Usui M, Minami M, Ishii S. Successful replantation of an amputated leg in a child.  Plast Reconstr Surg . 1979;  63 613-617
    CrossrefPubMedGoogle Scholar
  • 12 Usui M, Ishii S, Muramatsu I, Takahata N. An experimental study on “replantation toxemia”. The effect of hypothermia on an amputated limb.  J Hand Surg . 1978;  3A 589-596
    PubMedGoogle Scholar
  • 13 Engber W D, Hardin C A. Replantation of extremities.  Surg Gynecol Obstet . 1971;  132 901-916
    PubMedGoogle Scholar
  • 14 Lesavoy M A. Successful replantation of the lower leg and foot, with good sensibility and function.  Plast Reconstr Surg . 1979;  64 760-765
    PubMedGoogle Scholar
  • 15 Yaffe B, Borenstein A, Seidman D, Amit Y. Successful replantation of both legs in a child-5-year follow-up: a case report.  J Trauma . 1991;  31 264-267
    CrossrefPubMedGoogle Scholar
  • 16 Krylov V S, Milanov N O, Peradze T Y. et al . Lower leg replantation: railroad amputation.  J Reconstr Microsurg . 1987;  3 321-325
    PubMedGoogle Scholar
  • 17 Ramazi O D. Simultaneous replantation of both lower legs in a child: a long-term result.  Plast Reconstr Surg . 1993;  91 541-547
    PubMedGoogle Scholar
  • 18 Morrison W A, O'Brien B M, MacLeod A M. Major limb replantation.  Orthop Clin N Am . 1977;  8 343-348
    PubMedGoogle Scholar
  • 19 Mamakos M S. Lower extremity replantation-two and a half-year follow-up.  Ann Plast Surg . 1982;  8 305-309
    CrossrefPubMedGoogle Scholar
  • 20 Nincovic M, Deetjen H, Ohler K. et al . Emergency free tissue transfer for severe upper extremity injuries.  J Hand Surg . 1995;  20B 53-58
    PubMedGoogle Scholar
  • 21 Costa H, Guimaraes I, Cardoso A. et al . One-stage coverage and revascularisation of traumatized limbs by a flow-through radial mid-forearm free flap.  Br J Plast Surg . 1991;  44 533-537
    PubMedGoogle Scholar
  • 22 Ao M, Nagase Y, Namba Y. Reconstruction of post-traumatic defects of the foot by flow-through anterolateral or anteromedial thigh flaps with preservation of posterior tibial vessels.  Ann Plast Surg . 1995;  34 585-592
    PubMedGoogle Scholar
      >