ABSTRACT
Above-knee amputations are rare injuries that need emergent replantation or primary
amputation. Although survival could be achieved in selective cases, postoperative
function of the affected limb is usually unsatisfactory and a late amputation has
to be performed for poor prognosis or severe complications. Experience of the surgical
team may play an important role in primary decision making, which leads us to report
one case of above-knee replantation with poor postoperative function and needing a
late amputation. Scoring systems, expected results based on our case, and a brief
review of literature concerning above-knee replantations are discussed.
KEYWORDS
Replantation - above-knee amputation - decision making
REFERENCES
- 1
Chen Z W.
Progress in limb and digital replantation: Part A—introduction.
World J Surg.
1990;
14
804-806
- 2
Hierner R, Betz A M, Comtet J J, Berger A C.
Decision making and results in subtotal and total lower leg amputations: reconstruction
versus amputation.
Microsurgery.
1995;
16
830-839
- 3
Schmidhammer R, Nimmervoll R, Pelinka L E et al..
Bilateral lower leg replantation versus prosthetic replacement: long-term outcome
of amputation after an occupational railroad accident.
J Trauma.
2004;
57
824-831
- 4
Kocher M S.
History of replantation: from miracle to microsurgery.
World J Surg.
1995;
19
462-467
- 5
Pederson W C.
Replantation.
Plast Reconstr Surg.
2001;
107
823-841
- 6
Chung-Wei C, Yun-Qing Q, Zhong-Jia Y.
Extremity replantation.
World J Surg.
1978;
2
513-524
- 7
Battiston B, Tos P, Pontini I, Ferrero S.
Lower limb replantations: indications and a new scoring system.
Microsurgery.
2002;
22
187-192
- 8
Friedel R, Schmidt R, Dönicke T, Hüttemann E, Bach O, Hofmann G O.
Above-knee replantation following traumatic bilateral amputation: sciatic nerve transplantation.
Eur J Trauma Emerg Surg.
2007;
33
192-197
- 9
Nasseri M, Voss H.
Late results of successful replantation of upper and lower extremities.
Ann Surg.
1973;
177
121-125
- 10
Hierner R, Berger A K, Frederix P R.
Lower leg replantation—decision-making, treatment, and long-term results.
Microsurgery.
2007;
27
398-410
- 11
Lange R H.
Limb reconstruction versus amputation decision making in massive lower extremity trauma.
Clin Orthop Relat Res.
1989;
243
92-99
- 12
Meyer V E.
Upper extremity replantation—a review.
Eur Surg.
2003;
35
167-173
- 13
Werner C M, Exner G U, Dumont C E.
Free vascularised osteocutaneous filet flap for covering, that permitted sensitive
terminal weight-bearing by a thigh stump after transfemoral amputation.
Scand J Plast Reconstr Surg Hand Surg.
2006;
40
315-317
- 14
Tamai S.
Twenty years’ experience of limb replantation—review of 293 upper extremity replants.
J Hand Surg [Am].
1983;
7
549-556
- 15
Cavadas P C, Landín L, Ibáñez J, Roger I, Nthumba P.
Infrapopliteal lower extremity replantation.
Plast Reconstr Surg.
2009;
124
532-539
C.-Q. ZhangM.D. Ph.D.
Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital
Shanghai Jiao Tong University, Shanghai 200233, China
eMail: changqing_1914@yahoo.cn