Authors: Jimenez-Martinez CA, González-Jiménez B, Huerta- Rivadeneyra FJ, Mata-Sansores LE, Morgado-Oropeza VR, Torres-Hernández RM.
Introduction: Microsurgical reimplantation in patients faces challenges due to complex factors, concerning the comorbidities of the patient and the type and severity of the amputation. The one-year survival rate is 90, 9% [1]. Plastic surgeons and a multidisciplinary team will be needed to perform microsurgical techniques, such as the use of tridimensional models to reconstruct different body parts using top-notch technology [2]. This study aims to evaluate the technique of reimplantation of the third proximal left arm in a patient with a traumatic amputation.
Background of the Case Study: 49-years old man suffered an amputation of his left forearm by an industrial grinding machine in his workplace on October 5th, 2017, which resulted in a total avulsion of his limb. The patient was taken to the Emergency room to perform a warm ischemic technique for around 30 minutes. Physicians kept the amputated forearm on ice for 3 hours and conducted the intraoperative ischemia for 4 hours. The surgery included an extent debridement of the devitalized muscles, injured tendons and vessels, and the osteosynthesis of the radius and ulna without complications. After one year, researchers conducted the metacarpophalangeal capsuloplasty, tenolysis of the extensors and opening of the first space and section of the pronator quadratus.
Conclusion: Revascularization within the first four hours was crucial because it prevented permanent damage to the tissues. The surgery technique focused on the reconstruction of the viable tissues, resulted in the reimplantation of the forearm.
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