ABSTRACT
Treatment of mutilating hand injuries often requires multiple innovative procedures.
This report describes a case of multi-limbed amputations from a train injury and the
extraordinary microsurgical approaches for a two-hand reconstruction. The first stage
of the procedure was a cross replantation of the left foot to the right leg. The second
stage was a combined second and third toe transfer from the cross replantation of
the left foot to the right hand, and a sensate fibular osteocutaneous flap transfer
for left hand reconstruction. Satisfactory function was restored, including good protective
sensation. These kinds of extraordinary microsurgical approaches are useful salvage
procedures for hand reconstruction, when presented with a case of multi-limb amputation
KEYWORDS
Cross-foot replantation - toe-to-hand transfer - ectopic implantation
REFERENCES
- 1
Malt R A, McDowell F.
Cable from Cathay.
N Engl J Med.
1973;
288
1353-1354
- 2
Wang D, Yin Y S, Gao F G, Lu Z, Hu S B.
Cross replantation of lower extremities in multilimbed amputation. Case report and
literature review in China.
J Trauma.
1995;
38
947-951
- 3
Betz A M, Stock W, Hierner R, Schweiberer L.
Cross over replantation after bilateral traumatic lower leg amputation. A case report
with six-year follow up.
J Reconstr Microsurg.
1996;
12
247-255
- 4
Kutz J E, Sinclair S W, Rao V, Carlier A.
Cross hand replantation. Preliminary case report.
J Microsurg.
1982;
3
251-254
- 5
Adkins P, Graham B, Kutz J E.
Functional evaluation of an emergency cross hand replantation: a 9-year follow up.
J Hand Surg.
1992;
17A
214-216
- 6
May Jr J W, Rothkopf D M, Savage R C, Atkinson R.
Elective cross hand transfer: a case report with a five year follow up.
J Hand Surg.
1989;
14A
28-34
- 7
Reagan D S, Reagan J M.
Emergency cross arm transfer.
Plast Reconstr Surg.
2000;
106
648-652
- 8
Yildirim S, Akan M, Akoz T.
Transmetacarpal cross-hand replantation as a salvage procedure in a case of traumatic
bilateral upper extremity amputation.
Plast Reconstr Surg.
2003;
112
1350-1354
- 9
Godina M, Bajec J, Baraga A.
Salvage of the mutilated upper extremity with temporary ectopic implantation of the
undamaged part.
Plast Reconstr Surg.
1986;
78
295-299
- 10
Chernofsky M A, Sauer P F.
Temporary ectopic implantation.
J Hand Surg.
1990;
15A
910-914
- 11
Yousif N J, Dzwierzynski W W, Anderson R C, Matloub H S, Sanger J R.
Complications and salvage of an ectopically replanted thumb.
Plast Reconstr Surg.
1996;
97
637-640
- 12
Graf P, Groner R, Horl W, Schaff J, Biemer E.
Temporary ectopic implantation for salvage of amputated digits.
Br J Plast Surg.
1996;
49
174-177
- 13
Wei F C, El Gammal T A.
Toe to hand transfer: current concepts, techniques and research.
Clin Plast Surg.
1996;
23
103-116
Serkan YildirimM.D.
Kozyatagi mah. Sakaci sok., Altýngeyikler apt. 52/23
34742 Kadiköy, Istanbul, Turkey
