1.A Case of Successful Penile Replantation.
Kwang Sung PARK ; Dae Sik MOON ; Soo Beng RYU ; Byung Kap MIN
Korean Journal of Urology 1990;31(4):631-634
Traumatic amputation of a penis is an unusual injury. Amputation of the penis occurs most commonly as an act of self-emasculation, but has also been reported as resulting from assaults or accidental dismemberments. We report a case of successful clinical replantation of an amputated penis resulting from assaults by using a microvascular surgery.
Amputation
;
Amputation, Traumatic
;
Male
;
Penis
;
Replantation*
3.Successful replantation of both lower legs in a 41-year-old man.
Guang YU ; Hong-Yu LEI ; Shuang GUO ; Hao YU ; Jian-Hua HUANG ; Sheng-Hai LIANG
Chinese Journal of Traumatology 2011;14(4):250-252
Both severed legs were replanted in a 41-year-old man. Bilateral tibia and fibula were shortened by 4 cm equally. Tibial fixation was performed with reconstruction plate. Four weeks after the replantation, active and passive exercises were initiated in both of the knee joints. Four months after surgery, the patient was capable of walking independently for 20-30 m without the aid of crutches. After 28 months' follow-up, plantar sensitivity was defined as S3. This patient was satisfactory with the cosmetic and functional results.
Amputation, Traumatic
;
surgery
;
Fibula
;
Humans
;
Leg
;
Male
;
Replantation
;
Tibia
4.Finger Tip Composite Grafting Managed with Moist-Exposed Dressing.
Daegu SON ; Hojun CHU ; Hyeonjung YEO ; Junhyung KIM ; Kihwan HAN
Journal of the Korean Society for Surgery of the Hand 2012;17(1):9-15
PURPOSE: The purpose of this study was to determine whether keeping the wound moist improves the results of composite grafting of amputated fingertip. MATERIALS AND METHODS: Between 1997 and 2010, 93 patients with traumatic amputation of 100 digits have undergone composite finger tip graft. The hand was kept elevated and a topical antibiotics was frequently applied to avoid desiccation. Their ages ranged from 10 months to 73 years. We assessed the success rate based on age, amputation level, ischemic time and etiology. RESULTS: Of these 100 composite grafts, grafting had been successful in 65. Evaluation by age revealed that grafting had been successful in 13 of 18 fingers among patients less than 6 years old, in four of five fingers among those 6 to 15 years old and in 48 of 77 fingers among those 16 years of age and older. Assessment by level of amputation showed that grafting had been successful in 37 of 56 fingers amputated in zone I, in 12 of 19 fingers amputated in zone II and in 16 of 25 fingers amputated in zone III. No statistically significant differences in graft survival were found in relation to age, amputation level, ischemic time or type of amputation. CONCLUSION: Our results demonstrate that composite finger tip graft in adult is feasible and a very high rate of survival is obtained. We believe that moist-exposed dressings should improve the success rate associated with fingertip composite grafting.
Adult
;
Amputation
;
Amputation, Traumatic
;
Anti-Bacterial Agents
;
Bandages
;
Desiccation
;
Fingers
;
Graft Survival
;
Hand
;
Humans
;
Replantation
;
Transplants
5.Sonographically Guided Alcohol Injection in Painful Stump Neuroma.
Kil Byung LIM ; Young Sup KIM ; Jeong A KIM
Annals of Rehabilitation Medicine 2012;36(3):404-408
Stump neuroma is a common cause of pain from disorganized proliferation of nerve fascicles occurring after limb amputation. Ultrasound guided alcohol injection in painful stump neuroma has been tried as a new treatment approach. Herein, we report 2 male patients, who had traumatic amputation and claimed severe and diffuse burning pain in the stump area. Neuroma at the distal end of an amputated nerve was clearly identified on sonography. The patients gradually developed increasing severe pain that could not be managed with conservative care. They were treated with neurolysis using alcohol solution. Using ultrasonographical guidance, 1.2 ml of 100% dehydrated alcohol was injected into the nerves proximal to neuroma. No complications occurred. The patients were initially pain free. After a few months, however, their stump pain recurred slightly. Repeat neurolysis was performed using 0.3 ml of 100% dehydrated alcohol. During the three months follow-up period, mild stump pain occurred but the patients did not require any analgesics.
Amputation
;
Amputation, Traumatic
;
Analgesics
;
Burns
;
Extremities
;
Follow-Up Studies
;
Humans
;
Male
;
Neuroma
6.Ectopic major transplantation for salvage of upper and lower extremity amputations.
Shahram NAZERANI ; Hamed VASEGHI ; Saied HESAMI ; Tina NAZERANI
Chinese Journal of Traumatology 2013;16(6):330-333
OBJECTIVEEctopic tissue transplantation is not a new idea. Godina and his colleagues pioneered this method in the 1980s. This method is a last resort method of preserving an amputated body part, which consists of banking the amputated segment in an ectopic area and returning it to its native place at a later date. In this article we present our experience with this demanding procedure.
METHODSDebridement was the mainstay of this procedure. The stump and amputated part are carefully debrided and the stump was either closed primarily or covered by a flap. The amputated part was transplanted to one of several banking sites in the body and at a later date it will be transferred to its native site in an elective setting.
RESULTSSeven patients meeting the set criteria for ectopic transplantation were enrolled in this study. The overall success rate was about 70%, lower than expected but these are cases of severe crush injury. Although the functional recovery of these patients are very low, all of the successful cases except one could find a job as a janitor or light manual worker. No patient could return to his previous job.
CONCLUSIONEctopic transplantation of body parts is an accepted method of treatment of severely crushed extremity or finger injuries. In our country an amputee has very little chance of finding a job instead a disabled person can. In addition in Iran cultures amputation is seen as punishment of either the God or the society, so it is not well accepted and many patients persist on saving the limb even with no functional recovery. None of our successful cases could return to his previous occupation but almost all of them could find a job as janitors or light manual workers.
Amputation ; Amputation, Traumatic ; surgery ; Finger Injuries ; surgery ; Humans ; Lower Extremity ; Replantation
7.Pollicization: Two Cases report
Young Joe KIM ; Byung Yong KO ; Keun Yull MAING ; Dong Myung YOO
The Journal of the Korean Orthopaedic Association 1980;15(3):599-603
Absence of the thumb, either traumatic or congenical, causes a severe deficiency in hand function; in fact grasp and pinch are almost impossible. Thus when the thumb is partially or totally absent, reconstructive surgery is appealing. Usually the thumb should be reconstructed only when amputation has been at the metacarpophal-angeal joint or at a more proximal level. The procedures for reconstruction of the thumb are well known. They include transposition of a digit, procedures to lengthen the thumb metacarpal and methods of total reconstruction including a pedicle graft to obtain sensibility. Although pollicization (transposition of a finger to replace an absent thumb) endangers the finger, that is worthwhile, especially in complete bilateral absence of the thumb or in bilateral traumatic amputation. The each finger with a part or the whole of the metacarpal, has been transplanted to the stump of the metacarpal of the thumb or the trapezium. When all of the fingers are normal, the index finger is the best choice for thumb replacement because of its circumferential size, phalangeal length, independent motion and proximity to the thenar eminence. Recently this operation has been done with conservation of all nerves, vessels, tendons and muscles. We have had two pollicization operations (transposition of index finger) in the patient of bilateral traumatic amputation of the thumbs. Four months later excellent pinch and grasp with normal sensibility in the reconstructed thumbs were obtained with all remaining digits.
Amputation
;
Amputation, Traumatic
;
Fingers
;
Hand
;
Hand Strength
;
Humans
;
Joints
;
Muscles
;
Tendons
;
Thumb
;
Transplants
8.A Case of Verrucous Hyperplasia with Lymphedema of the Leg Amputation Stump.
Ki Seung DOH ; Tae Sik CHOI ; Jae Young SEONG ; Kee Suck SUH ; Sang Tae KIM
Korean Journal of Dermatology 2001;39(8):953-955
Verrucous hyperplasia shows multiple warty like lesion on the amputation stump, but the pathologic findings of viral verrucae has not been discovered. A verrucous plaque on the amputation stump of the right leg was found in 31-year-old man. He had suffered from a traumatic amputation of right leg since 8 years ago. A leg prosthesis had been worn since that time. Histopathologic findings shows hyperkeratosis, acanthosis, papillomatosis, superficial dermal edema and dilated thick-walled venules oriented vertical to the skin surface. Verrucous hyperplasia was diagnosed with lymphedema on the basis of clinical and histological findings.
Adult
;
Amputation Stumps*
;
Amputation*
;
Amputation, Traumatic
;
Artificial Limbs
;
Edema
;
Humans
;
Hyperplasia*
;
Leg*
;
Lymphedema*
;
Papilloma
;
Skin
;
Venules
;
Warts
9.A Case of Verrucous Hyperplasia with Lymphedema at the Distal Stump of a Below-the-knee Amputee.
Hae Woong LEE ; Ho Seok SUH ; Mi Woo LEE ; Jee Ho CHOI ; Kee Chan MOON ; Jai Kyoung KOH
Korean Journal of Dermatology 2004;42(8):1076-1078
Verrucous hyperplasia of the distal stump skin is a rare condition which shows multiple, irregular warty papules and plaques but histologically no evidence of viral warts. It has been suggested that verrucous hyperplasia results from persistent stump edema, usually when the distal stump is unsupported in the prosthesis socket. We present a 53-year-old male who showed verrucous plaques on the distal stump skin and also showed edematous change with oozing. He has been wearing a below-the-knee prosthesis for 35 years since a traumatic amputation and has not changed the prosthesis for 30 years. Histopathological findings showed hyperkeratosis, parakeratosis, acanthosis, papillomatosis, dermal edema, fibrosis, dermal vessel proliferation and dilatation. He was diagnosed as having verrucous hyperplasia with lymphedema by clinical and histopathological findings.
Amputation
;
Amputation, Traumatic
;
Amputees*
;
Dilatation
;
Edema
;
Fibrosis
;
Humans
;
Hyperplasia*
;
Lymphedema*
;
Male
;
Middle Aged
;
Papilloma
;
Parakeratosis
;
Prostheses and Implants
;
Skin
;
Warts
10.Free fillet foot flap for salvage of below-knee amputation stump.
Lei CHEN ; Fan YANG ; Zhi-Xin ZHANG ; Lai-Jin LU ; Jin HIROMICHI ; Toh SATOSHI
Chinese Journal of Traumatology 2008;11(6):380-384
Management of extensive bone and soft tissue defects, which occur after severe trauma of lower extremities and always lead to an unacceptable amputation in some cases, continues to challenge reconstructive surgeons. When performing lower extremity amputation, preservation of the knee joint has been put into a higher priority. The benefit of below-knee amputation over above-knee ones concentrates on a more normal gait with less energy expenditure during ambulation when a functioning knee joint is present.
Accidents, Traffic
;
Amputation Stumps
;
Amputation, Traumatic
;
surgery
;
Foot Injuries
;
surgery
;
Humans
;
Infant
;
Leg Injuries
;
surgery
;
Male
;
Surgical Flaps