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Replantation of the Forearm or Arm

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Book cover Extremity Replantation

Abstract

Amputations through the forearm, elbow, or arm are distinguished from their distal counterparts based on fundamental differences inherent to the anatomy of the level. Of primary concern, the increased muscle mass involved makes replantation more risky and functional outcomes often less satisfying. Restoring perfusion to the distal part is of paramount importance to prevent ischemic myonecrosis. As a general rule, replantation should not be considered if the warm ischemia time exceeds 6 h and should be undertaken with great caution if longer than 4 h for proximal forearm, elbow, or transhumeral amputations. Given the high energy associated with these injuries, the replant surgeon should be cognizant of the physiologic status of the patient. Multiple transfusions are often needed. As a general rule, outcomes improve as level of amputation moves distally and with sharp, clean mechanisms.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, USA

    Michael Waters MD & Brian J. Harley MD, FRCSC

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  1. Michael Waters MD
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  2. Brian J. Harley MD, FRCSC
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Correspondence to Brian J. Harley MD, FRCSC .

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Editors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    A. Neil Salyapongse

  2. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    Samuel O. Poore

  3. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    Ahmed M. Afifi

  4. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    Michael L. Bentz

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Waters, M., Harley, B.J. (2015). Replantation of the Forearm or Arm. In: Salyapongse, A., Poore, S., Afifi, A., Bentz, M. (eds) Extremity Replantation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7516-4_7

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