Wood M B, Cooney W P
J Hand Surg Am. 1986 Sep;11(5):682-7. doi: 10.1016/s0363-5023(86)80012-0.
Seven patients with a complete transhumeral limb amputation had their limb replanted. In all seven limbs the mechanism of injury was avulsion, and the ischemic time was relatively prolonged, with a range of 10 to 14 hours. The five patients with surviving limbs achieved useful elbow control. Of these patients, two achieved useful distal function to the wrist and hand and one had a below elbow amputation. All but one patient required multiple secondary operative procedures, with an average of 2.8 procedures for those patients with surviving limbs. We did not encounter any significant life-threatening problems. Less serious complications were encountered in all but three patients during the postoperative period. We suggest that limb replantation at transhumeral levels may be of value for recovery of elbow function in most of these patients. In some instances, this may permit the conversion of an above elbow level amputation to a functional below elbow level. In a few patients, recovery of useful hand function may be achieved.
7例经肱骨完全性肢体离断患者接受了肢体再植手术。所有7例肢体的损伤机制均为撕脱伤，且缺血时间相对较长，范围为10至14小时。5例肢体存活的患者获得了有效的肘关节控制。在这些患者中，2例获得了有效的腕部和手部远端功能，1例为肘下截肢。除1例患者外，所有患者均需多次二期手术，肢体存活的患者平均接受2.8次手术。我们未遇到任何严重危及生命的问题。除3例患者外，所有患者在术后均出现了不太严重的并发症。我们认为，经肱骨水平的肢体再植对于大多数此类患者的肘关节功能恢复可能具有价值。在某些情况下，这可能使肘上截肢转变为功能性肘下截肢。在少数患者中，可实现有效的手部功能恢复。
