[Total replacement of an arm amputated near the shoulder. Difficulties during anesthesia and ressuscitation (author's transl)].

The authors report a recent observation of the total replacement of an arm amputated near the shoulder. The limb was perfused and cooled down from the site of the accident to the general hospital (distance about 50 miles) and was replanted within 13 hours. The procedure itself lasted about 8 hours. The bone replantation was the most critical difficulty for the surgeons. Venous repair was associated with hemorrhage and massive transfusion had to be performed to compensate heavy blood loss. In the post-operative period acute renal insufficiency and septicemia developed. After ten days an arterial rupture occurred and emergency amputation was performed. Recovery was uneventful and the patient was discharged nine weeks after his admission, his renal function being quite restored. The authors compare the hazards of this kind of operation and the chance of recovery of the functions of a replanted limb. They conclude by emphasizing the necessity of carefully choosing the cases for total arm replacement.