Hand, Upper Limb & Peripheral Nerve Surgery Department, Georges-Pompidou European Hospital (HEGP), 20, Rue Leblanc, 75015 Paris, France.
Institut Robert Merle d'Aubigné, 2, Rue Emilion Michaud et Lucien Rabeux, 94460 Valenton, France.
Hand Surg Rehabil. 2022 Feb;41S:S71-S75. doi: 10.1016/j.hansur.2020.09.018. Epub 2021 Oct 4.
Hand amputation can be discussed after traumatic brachial plexus injury when the patient's hand is non-functional, painful and/or insensitive. That indication is more common in English-speaking countries than in European or Latin countries. New prostheses are now on the market and can be used after hand amputation to improve the functional prognosis in well-selected patients. A 26-year-old male was involved in a road accident in January 2016. He had a traumatic brachial plexus injury and underwent nerve surgery to restore the biceps brachii and triceps brachii. One year after nerve transfer, his hand was insensitive and non- functional. After multidisciplinary consultation, it was decided to amputate his hand to replace it with a myoelectric prosthesis. Shoulder subluxation pain and complications associated with an insensitive and heavy arm were improved after hand amputation. Functional outcomes were improved with this revolutionary myoelectric prosthesis technique. The patient was able to use his prosthesis for many daily activities. Selective amputation indications after traumatic brachial plexus injury are a heavy and stiff arm with shoulder subluxation pain and an unusable claw hand. The patient's motivation must be high.
当患者的手失去功能、疼痛和/或感觉丧失时,可以考虑进行手部截肢,这在讲英语的国家比在欧洲或拉丁国家更为常见。现在市场上有新的假肢,可以在手截肢后用于改善精选患者的功能预后。一名 26 岁男性于 2016 年 1 月发生道路交通事故。他患有创伤性臂丛神经损伤,并接受了神经手术以恢复肱二头肌和肱三头肌。神经转移 1 年后,他的手失去了感觉且无法活动。经过多学科咨询,决定截肢以更换肌电假肢。手部截肢后,肩部半脱位疼痛和手臂感觉迟钝沉重引起的并发症得到改善。这种革命性的肌电假肢技术改善了功能结果。患者能够使用他的假肢进行许多日常活动。创伤性臂丛神经损伤后的选择性截肢指征是肩部半脱位疼痛和无法使用的爪形手的沉重和僵硬的手臂。患者的积极性必须很高。