Andre A, Rongieres M, Laffosse J-M, Pailhe R, Lauwers F, Grolleau J-L
Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France; Laboratoire d'anatomie, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
Institut de l'appareil locomoteur, unité de chirurgie de la main et chirurgie réparatrice des membres, hôpital Pierre-Paul-Riquet, centre hospitalier universitaire de Toulouse, place Baylac, 31059 Toulouse cedex, France; Laboratoire d'anatomie, faculté de médecine, 133, route de Narbonne, 31400 Toulouse, France.
Ann Chir Plast Esthet. 2015 Aug;60(4):340-5. doi: 10.1016/j.anplas.2014.11.003. Epub 2014 Dec 12.
Bilateral amputations of upper limbs are excessively rare clinical situations. We report an exceptional clinical case of bilateral amputation of upper limbs at different levels: destruction of the right hand and left transhumeral amputation in a patient after an attempted suicide on train lines. This special situation led us to perform a cross-hand replantation of the left hand to the right forearm. Only 4 other similar cases have been published in the literature. Once the surgical indication had been formulated collectively, and taking into account all the ethical issues surrounding such a decision, we had to solve the issue of inverting anatomical structures in emergency. We have provided a detailed description of our surgical technique. The aim was to save at least one organ used for grasping. The result obtained is presented and reviewed.
双侧上肢截肢是极为罕见的临床情况。我们报告了一例特殊的临床病例，患者双侧上肢在不同平面截肢：因试图卧轨自杀，右手毁损，左手经肱骨截肢。这种特殊情况促使我们将左手交叉再植至右前臂。文献中仅另外报道过4例类似病例。在共同确定手术指征并考虑到围绕该决定的所有伦理问题后，我们必须在紧急情况下解决解剖结构倒置的问题。我们详细描述了我们的手术技术。目的是至少保留一个用于抓握的器官。展示并回顾了所取得的结果。
