J Reconstr Microsurg 2015; 31(09): 681-683
DOI: 10.1055/s-0035-1558429
Letter to the Editor: Short Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lower Limb Replantation after Guillotine Amputation: A 29-Year Follow-Up

Niels H. Bosma
1   Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Teun Teunis
1   Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Kyle R. Eberlin
2   Division of Plastic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
,
Jesse B. Jupiter
1   Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
› Author Affiliations
Further Information

Publication History

11 June 2014

21 May 2015

Publication Date:
18 September 2015 (online)

Lower extremity traumatic amputations are relatively rare and mostly the result of high-energy motor vehicle or motorcycle accidents. These injuries predominantly affect a young population. Although there is a debate about the indications for replantation, much of the published literature tends to favor primary revision amputation with subsequent use of a prosthetic. Despite this, there are numerous possible drawbacks of a revision amputation including neuromas, stump problems, derangement of the patient's body self-image, and diminished function.[1]

Alternatively, replantation of an amputated lower extremity has the chance to replace “like with like” and may offer superior functional outcomes. However, there are few reported cases with long-term follow-up to help better define the indications and possible outcomes. This case report describes a 29-year follow-up of successful lower extremity replantation.

 
  • References

  • 1 Gayle LB, Lineaweaver WC, Buncke GM , et al. Lower extremity replantation. Clin Plast Surg 1991; 18 (3) 437-447
  • 2 Chung-Wei C, Yun-Qing Q, Zhong-Jia Y. Extremity replantation. World J Surg 1978; 2 (4) 513-524
  • 3 Salon A, Liverneaux PA, Dubert T, Bleton R, Alnot JY. Long-term review of five leg replantations: emergency strategy and examples of lengthening of the leg on nerve regeneration. Injury 2006; 37 (9) 869-876
  • 4 Datiashvili RO. Simultaneous replantation of both lower legs in a child: 23 years later. J Reconstr Microsurg 2009; 25 (5) 323-329
  • 5 Fufa DT, Lin CH, Lin YT, Hsu CC, Lin CH. Survival and secondary surgery following lower extremity replantation. J Reconstr Microsurg 2014; 30 (6) 419-426
  • 6 Kutz JE, Jupiter JB, Tsai TM. Lower limb replantation. A report of nine cases. Foot Ankle 1983; 3 (4) 197-202
  • 7 Cavadas PC, Landín L, Ibáñez J, Roger I, Nthumba P. Infrapopliteal lower extremity replantation. Plast Reconstr Surg 2009; 124 (2) 532-539
  • 8 Hierner R, Berger AK, Frederix PR. Lower leg replantation—decision-making, treatment, and long-term results. Microsurgery 2007; 27 (5) 398-410
  • 9 Helfet DL, Howey T, Sanders R, Johansen K. Limb salvage versus amputation. Preliminary results of the Mangled Extremity Severity Score. Clin Orthop Relat Res 1990; (256) 80-86
  • 10 Tantry TP, Kadam D, Shenoy SP, Bhandary S, Adappa KK. Perioperative evaluation and outcomes of major limb replantations with ischemia periods of more than 6 hours. J Reconstr Microsurg 2013; 29 (3) 165-172