Limb salvage procedures for mutilated forearm injuries

Abstract

Objective To report the limb salvage experience in patients with mutilated forearm severance. Methods From September 2012 to October 2014, 8 severed forearms with mutilated injuries were salvaged by shortening and replantation of the forearm after emergency debridement. Results The replants survived in all 8 cases. Postoperative follow-up ranged from 6 to 24 months. Based on the evaluation criteria for the upper extremity issued by the Hand Surgery Society of the Chinese Medical Association, functions of the salvaged forearms were rated as excellent in 1 case, good in 5 cases, and poor in 2 cases. Postoperative complications included arterial crisis in 1 case that was rescued by surgical exploration and vascular re-anastomosis; severe infection in 1 case that was successfully managed with antibiotics treatment; forearm fracture nonunion in 1 case that was healed with secondary fixation and bone graft; and tendon adhesion in 1 case that was treated with secondary tenolysis. Conclusion Limb-salvage procedures should be considered in mutilated forearm severance cases when conditions allow. Reasonable functional outcomes can be expected. Key words: Forearm; Treatment outcome; Mutilated injuries; Limb salvage