TITLE

Above-Knee Replantation Following Traumatic Bilateral Amputation: Sciatic Nerve Transplantation

AUTHOR(S)
Friedel, Reinhard; Schmidt, Ralf; Dönicke, Torsten; Hüttemann, Egbert; Bach, Olaf; Hofmann, Gunther O.
PUB. DATE
April 2007
SOURCE
European Journal of Trauma & Emergency Surgery;Apr2007, Vol. 33 Issue 2, p4
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
A 12-year-old boy who was overrun by a train, sustained traumatic bilateral above-knee amputation and a rupture of the symphysis. The left leg had multiple fractures and soft tissue injuries and amputation was necessary. The right one, although severely crushed, at the amputation site and with a MESS of 9, was replanted accepting some shortening and a soft tissue defect at the amputation site, employing saphenic vein grafts from the amputate (left leg) and an early free latissimus dorsi-flap. Septic complications at the amputation site were managed, and an autologous sciatic nerve graft was performed 8 months after the accident, employing the contralateral above-knee stump as the donor. Protective foot sole sensitivity was noticed after 2 years and 4 months and continued to improve. Further reconstructive procedures included ORIF of a femoral fracture in the contra-lateral stump. On the replanted leg proximal tibia corrective osteotomy and lateral collateral knee ligament reconstruction were performed. A follow-up of 7 years and 9 months demonstrates now a leg capable of full weight bearing and recovery of overall protective sensitivity. The boy made good psycho-social progress after difficulties and feels that the replanted leg is of significantly greater use to him than the hi-tech prosthesis on the other leg.
ACCESSION #
25228952

 

Related Articles

  • Ultrasonically driven instruments in the transfemoral approach – an aid to preservation of bone stock and reduction of implant length. Fletcher, M.; Jennings, G. J.; Warren, P. J. // Archives of Orthopaedic & Trauma Surgery;Oct2000, Vol. 120 Issue 10, p559 

    The transfemoral approach to the femur with implantation of the Wagner SL stem provides a means of dealing with the difficult revision problems of extensive endosteolysis and with peri-prosthetic fractures. This surgical approach has been modified such that with the aid of an ultrasonically...

  • Sinus Floor Elevation Using an Osteotome Technique Without Grafting Materials or Membranes. Schmidlin, Patrick R.; Müller, Jakob; Bindl, Andreas; Imfeld, Thomas // International Journal of Periodontics & Restorative Dentistry;2008, Vol. 28 Issue 4, p400 

    This retrospective study aimed to radiographically assess sinus floor remodeling after using a modified osteotome technique without graft materials or membranes. After pilot drilling, residual bone was fractured and raised with the schneiderian membrane to the final implant length using...

  • The Oxford unicompartmental knee prosthesis: an independent 10-year survival analysis. Vorlat, Peter; Putzeys, Guy; Cottenie, Dominique; Van Isacker, Tom; Pouliart, Nicole; Handelberg, Frank; Casteleyn, Pierre-Paul; Gheysen, Filip; Verdonk, René; Verdonk, René // Knee Surgery, Sports Traumatology, Arthroscopy;Jan2006, Vol. 14 Issue 1, p40 

    One hundred forty-nine medial prostheses were implanted in 140 patients between 1988 and 1996. After a mean of 67 months 28 patients had died, without the need for revision. Seventeen prostheses were lost to follow-up. Revision surgery using a total knee prosthesis was performed in 16 cases. In...

  • Immediate loading of single SLA implants: drilling vs. osteotomes for the preparation of the implant site.  // Journal of Oral Implantology;2008, Vol. 34 Issue 2, p119 

    The article presents a review of the article "Immediate Loading of Single SLA Implants: Drilling Vs. Osteotomes for the Preparation of the Implant Site," by A. Stavropoulos, J. Nyengaard, N. Lang and T. Karring. The paper presents a comparison of the healing of bone adjacent to implants placed...

  • The development of a model for in vitro testing of femoral stems in impaction bone grafting. Heal, J. S.; Gozzard, C.; Gheduzzi, S.; Grimm, B.; Learmonth, I. D.; Miles, A. W. // Proceedings of the Institution of Mechanical Engineers -- Part H;May2007, Vol. 221 Issue 4, p377 

    Comprehension of the biomechanical behaviour of orthopaedic implants is essential. This paper describes the development of an in vitro model to investigate the behaviour of femoral implants in the revision setting. The development of a femoral model and a bone graft substitute is described. The...

  • Effects of Different Abutment Connection Designs on the Stress Distribution Around Five Different Implants: A 3-Dimensional Finite Element Analysis. Balik, Ali; Karatas, Meltem Ozdemir; Keskin, Haluk // Journal of Oral Implantology;Special Issue 1, Vol. 38, p491 

    The stability of the bone-implant interface is required for the long-term favorable clinical outcome of implant- supported prosthetic rehabilitation. The implant failures that occur after the functional loading are mainly related to biomechanical factors. Micro movements and vibrations due to...

  • Combined Use of Bone Grafts and BrÃ¥nemark Fixtures in the Treatment of Severely Resorbed Maxillae. Kahnberg, K.-E.; Nyström, E.; Bartholdsson, L. // International Journal of Oral & Maxillofacial Implants;Winter1989, Vol. 4 Issue 4, p23 

    Bone grafts from the hip in combination with Brånemark self-tapping fixtures have been used to rehabilitate patients with extremely resorbed maxillae. Experiences and results from the first ten consecutive cases have been analyzed to form the basis for further use of the method. Eight of 57...

  • Functional outcome following ORIF of supracondylar intercondylar fracture Femur. Manohar, G.; Andrews, Shibu // Kerala Journal of Orthopaedics;Jan2012, Vol. 25 Issue 1, p1 

    Background: Supracondylar intercondylar fractures of femur are complex injuries which have been treated by different methods. The authors compare the functional outcome of the different methods of treatment with the published literature. Materials and methods: Supracondylar intercondylar...

  • Fixation of experimental osteotomies with bioabsorbable SR-polylactide–polyglycolide (80/20) polymeric rods. Mäkelä, Eeva; Mäkelä, E. Antero; Partio, Esa K.; Juutilainen, Timo; Lähteenkorva, Kimmo; Törmälä, Pertti; Rokkanen, Pentti // Journal of Materials Science: Materials in Medicine;Mar2008, Vol. 19 Issue 3, p1061 

    Self-reinforced polylactide–polyglycolide (80/20) composite rods, 2 mm in diameter and 36 mm in length, were implanted into the dorsal subcutaneous tissue of 20 rabbits. Osteotomies of the distal femur were fixed with these rods (2 × 15 mm) in the rabbits. The follow-up times varied...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics