Article

Replantation is the gold standard surgical treatment of amputations of the upper
limb; however, this demanding procedure is not always preformed in bilateral limb
amputation. The objective of this study was to analyze, six years after surgery,
the sensorimotor recovery of both replanted hands. A 21-year-old patient with
bilateral hand amputation was benefited from limb replantation. Surgery included
debridement of the amputated hands and recipient's stumps, bone fixation,
arterial and venous anastomoses, nerve sutures, tendon sutures and skin closure.
Rehabilitation program included physiotherapy, electrostimulation and
occupational therapy. Sensory and motor evaluation was performed 6 years after
replantation. At 6 years, the patient presented a good/satisfactory recovery of
range of motion and strength, better at right hand. The patient was able to
perform right thumb opposition. Static two-point discrimination was 20mm,
sensitivity to pain and thermal stimuli and ability to sweat were present on both
hands. Reinnervation was confirmed by electromyography. Functional recovery was
higher at the right hand when compared to the left hand. He was highly satisfied
with the result of surgery for right hand and fairly satisfied with the result
for left hand. He was able to return to a secretary work 16 months after the
accident. A proper functional result can be accomplished with bilateral hand
replantation.
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Langue : ANGLAIS