2017 Volume 31 Issue 3 Pages 395-399
Major replantation of the upper limbs is a frequent procedure due to the poor outcome of prosthetic substitutions. We report a case of an unsuccessful major upper limb replantation in a 40-year-old man. He had an occupational injury and major amputation in the middle one third of his forearm due to avulsion. There was a 10-cm defect in each of his median and ulnar nerves. In the first operation, reconstruction of vessels, and anatomical reduction and internal fixation of the radius and ulna were performed. However, reconstruction of the nerves was not performed. Ten days after the operation, we planned the reconstruction of his soft tissues with a latissimus dorsi flap and the transplantation of his nerves with bone shortening. However, bone shortening was impossible because of inflammation and oedema. Four months later, his limb became non-functional. This case suggests that primary bone shortening should be performed in the first operation of a major upper limb replantation.
