Minimally Invasive Shortening Humeral Osteotomy to Salvage a Through-Elbow Amputation

Abstract

Determine the efficacy of a novel surgical technique to salvage a through-elbow amputation and avoid revision transhumeral amputation. A 23-year-old soldier presented after sustaining a through-elbow amputation in a close-range blast injury with inadequate soft tissues to obtain closure over the distal humerus. A 2-cm anterior incision was made and a shortening osteotomy with percutaneous submuscular osteosynthesis was done. A myodesis was performed and a tension-free primary closure of the soft tissue envelope obtained. At 3 months postoperatively the osteotomy and soft tissue envelope were healed. At 2-year follow-up the patient reports using a body-powered prosthesis for ADLs and recreational hobbies, citing excellent rotational control and ease of prosthetic suspension. Minimally invasive shortening humeral osteotomy in the setting of a through-elbow amputation is a safe and effective procedure, which allows primary soft tissue closure, prevents the need for more proximal amputation, and allows for ease of prosthetic fitting and suspension.