Article

In front of a major upper limb trauma, do we need to make everything possible to
keep the limb with the risk of facing poor functional outcomes? This study was
performed to evaluate and compare long-term functional, psychological and social
outcomes following major upper extremity trauma between patients treated with
amputation and those who underwent limb salvage.
This was a retrospective
monocenter cohort study of 22 patients who sustained an upper limb injury
requiring either amputation or limb salvage. The characteristics of the patient,
trauma and initial take-care were studied. The outcomes of amputation and upper
limb salvage were compared by using functional scores (DASH, Chen), autonomy
(activities of the everyday life, work, driving, leisure activities),
psychological and quality of life evaluation (NHP, EVA, Russel's score).
Twenty-two patients were supported. Eleven limb salvages were performed with six
secondary amputations. Sixteen patients were reviewed: five with limb salvage and
11 amputees with a mean follow-up of 12 years and 5 months. All patients were
autonomous. There were no significant differences between both groups regarding
DASH and NHP scores or to work status and driving ability. Russel's score showed
that patients with salvaged upper limb were pleased to have kept it and would
recommend this treatment. Although the results of upper limb macro-replantation
are sometimes disappointing, the satisfaction for these patients to keep their
upper limb and their body integrity seems to justify such upper limb salvage when
it is technically possible.
CI - Copyright (c) 2013 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS