No abstract available.
Amputation*

No abstract available in English.
Amputation

No abstract available in English.
Amputation

The recognition and results of treatment of a few malignant tumors of the bone are briefly discussed in this paper. It is felt that, in order to obtain the best possible results from the management of the cases of malignant bone tumors, knowledge of such facts as are listed below is of definite value: (1) In primary malignancy of the bone, early radical excision or amputation, before metastases have occured, with or without radiotherapy, and the administration of Coleys mixed toxins, are the methods of choice(2) prevention of trauma and avoidance of delay in the performance of proper radical excision, instead of unwise empirical and palliative treatments, are measures which help decrease the incidence and mortality of malignancy of the bone. Palliative treatment finds its excuse and special indication in malignancies involving bones in hardly accessible locations like the vertebral bodies, etc. and as an adjunct to surgical excision(3) It is important to make early and accurate diagnosis of the conditions, if surgery is to yield worthwhile results. This makes it necessary to employ all known methods of examination, including careful history taking, physical examination, accurate roentgenological interpretation, laboratory studies, and biopsy. Unnecessary delay in its proper recognition through incomplete examinations and log drawn empirical treatment, without first ascertaining accurately the real nature of the condition, must be avoided(4) Early and accurate diagnosis of cancer of the different organs of the body is also of utmost importance. Its early recognition, followed by early radical excision of the tumor, usually results in preventing its dissemination or metastasis to the bones(5) Some secondary cancers (metastases) of the bone show regression as a result of such treatment as hormone therapy. This is illustrated by the bone metastases herein reported as having originated from cancer of the prostate and breast(6) Of interest is the apparent stimulation of the process of ossification in the bone lesions, which has been noted after the administration of hormone in cases of bone metastasis from cancer of the thyroid and osteolytic sarcoma. (Conclusion)
Amputation

A modification of the guillotine amputation is suggested, in order to take advantage of the free open drainage, and of the clean closure of the stump when such drainage is no longer necessaryA case report is summarized to illustrate the advantage of the methodDelayed suturing has been used in amputation in the aged, notably in a technic described by Callander but the advantages of the guillotine type were not sought or incorporatedThe stump may be closed in a short time - in this case six days after operation with the expectation that primary union will take placeThe correct type of flap for the intended prosthesis and the optimum thickness of the covering of the bone end may all be estimated and attained so that no further correction of the healed stump need be necessary. (Summary)
Amputation

PURPOSE: In cases of high voltage electrical burns, a wound occurs as current enters or leaves the body and is accompanied by deep tissue injury. If upper extremity amputation is inevitable, consideration should be given to the residual limb functions, secondary reconstruction, and wearing of an upper prosthesis. Our hospital has achieved satisfactory outcomes through the use of a pedicled latissimus dorsi (LD) flap in patients undergoing transhumeral amputation and shoulder disarticulation due to upper extremity damage from high voltage electrical burns. METHODS: The study was targeted to five patients who suffered high voltage electrical burns, underwent above-elbow amputation, and were reconstructed in the acute and secondary phases using a pedicled LD flap from January 2005 to December 2011. All patients underwent equilateral pedicled LD flap surgery, with primary closure at the donating site. RESULTS: The average age of patients was 49.6 years (38~64); they were all male. One patient underwent sublayer skin grafting after a pedicled muscular LD flap, and four patients had a pedicled myocutaneous LD flap: one patient among the four had a forearm flap after the pedicled myocutaneous LD flap. All flaps were well adhered, and post-surgical flap reduction and local flaps were performed for adequate sizing and aesthetic improvement. CONCLUSION: In cases of upper arm amputation due to wide upper extremity damage caused by electrical burns, the use of the pedicled LD flap and adequate amputation length made subsequent wearing of a prosthesis possible. The pedicled LD flap procedure allowed reconstruction of a relatively large area of soft tissue and the surgery to the donating site was unproblematic.
Amputation ; Amputation Stumps ; Arm ; Burns ; Disarticulation ; Extremities ; Forearm ; Humans ; Male ; Prostheses and Implants ; Shoulder ; Skin Transplantation ; Upper Extremity

Since the entity of postmastectomy lymphangiosarcoma was first reported by Stewart and Traves in 1948, postmastectomy lymphangiosarcoma has become a well recognized, uncommon malignant tumor which occurs in the upper extremity following mastectomy for mammary carcinoma. The postmastectomy lymphangiosarcoma occurred at an average age of 63.9 years and at an average of 10 years and 3 months following mastectomy. The lymphangiosarcoma raised from blood and lymphatic vessel. The histologic appearance has been observed edematous dermis and dilated lymphatics lining with malignant cells. Most authors recommend radical amputation for treatment, either shoulder disarticulation or forequarter amputation. Other modalities of treatment including radiotherapy were considered as ineffective. The present report provides a case of the regression of postmastectomy lymphangiosarcoma with chronic lymphedima by external irradiation. Radiation therapy was used as primary therapy. Total tumor dose of 6500 cgy in 9 weeks was delivered using 6 MV x-ray and 8 MeV electron.
Amputation ; Dermis ; Disarticulation ; Lymphangiosarcoma* ; Lymphatic Vessels ; Lymphedema ; Mastectomy ; Radiotherapy ; Shoulder ; Upper Extremity

Upper limb amputations usually leave a significant functional limitation in activities of daily living for the amputees despite the use of a conventional prosthesis. New developments in prosthetic design have greatly increased the rehabilitation potential for active individuals with the upper limb amputation. The application of external power to artificial hands and elbow, and elimination of the control cables, the most unpopular feature of body-powered arms, has had a great impact on upper-limb prosthetics in the last two decades. We applied a myoelectric hand to a traumatic amputee with wrist disarticulation. As a result, it was possible to provide a considerable improvement in function and cosmesis with this new device. Further research will undoubtly improve the appearance, function and durability of the present electrically powered myoelectrical hand, making them even more acceptable and useful to the upper limb amputees.
Activities of Daily Living ; Amputation ; Amputees ; Arm ; Disarticulation* ; Elbow ; Hand* ; Humans ; Prostheses and Implants ; Rehabilitation ; Upper Extremity ; Wrist*

Amputation stump pains can be developed in amputation sites after high voltage electrical burn injuries. We experienced one case of these severe stump pains in an upper extremity amputation patient. A 35-year-old man had a 38% total body surface area high voltage electrical burn. The patient underwent skin grafting and left shoulder disarticulation. During the rehabilitation period, he complained about severe stump area pains and phantom pains. We injected 0.5% Bupivacaine and Triamcinolone on the stump neuroma site but the pain sustained. After extracorporeal shock wave therapy (ESWT,) the pain subsided and did not recur. The patient was satisfied with functional and pain outcomes, so we report this case.
Adult ; Amputation ; Amputation Stumps ; Body Surface Area ; Bupivacaine ; Burns ; Disarticulation ; Humans ; Neuroma ; Phantom Limb ; Rehabilitation ; Shock* ; Shoulder ; Skin Transplantation ; Triamcinolone ; Upper Extremity

A 10-year-old boy with arteriovenous malformation (AVM) of the right lower limb was scheduled for an amputation of the affected limb. Limb amputation was necessary because of the ineffectiveness of previous sclerotherapy and the rapid progression of AVM causing pain and heart failure. Right hip disarticulation was considered the best option to improve his quality of life. To prevent congestive heart failure and uncontrollable hemorrhage during surgery, the disarticulation was done under a partial cardiopulmonary bypass. The patient underwent surgery successfully without complications.
Amputation ; Arteriovenous Malformations* ; Cardiopulmonary Bypass ; Child ; Disarticulation ; Extremities ; Heart Failure ; Hemorrhage ; Hip ; Humans ; Lower Extremity* ; Male ; Quality of Life ; Sclerotherapy