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Epidémiologie des amputations traumatiques du membre supérieur

POMARES G; COUDANE H; DAP F; DAUTEL G
REV CHIR ORTHOP TRAUMATOL , 2018, vol. 104, n° 2, p. 184-187
Doc n°: 186556
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.otsr.2017.12.014
Descripteurs : EB2 - AMPUTATION DU MEMBRE SUPERIEUR, HB1 - EPIDEMIOLOGIE

While published data on functional outcomes after upper limb amputations are plentiful, epidemiology data are relatively rare. This led us to
performing an epidemiology study of traumatic upper limb amputations at our
facility. METHODS: This retrospective study spanned a 10-year period
of cases seen at the SOS Main (Hand emergency center) of the Nancy University
Hospital in France. Patients who suffered traumatic amputation of the upper limb
were identified and divided into two groups: replantation and surgical amputation. All anatomical amputation levels were retained. Non-traumatic
amputations were excluded. Epidemiology data (sex, age, dominant side, injured
side) was collected along with the specific anatomical level of the injury, the
injury mechanism and whether it was work-related. We also looked at the success
rate of microsurgery and whether multi-finger amputations were partial or
complete. In parallel, the annual incidence of amputations seen at the SOS Main
over this period was calculated. RESULTS: Over the 10-year period, 1715 traumatic
upper-limb amputations were identified, which was 3% of all cases seen at the SOS
Main. Most of the cases involved middle-aged men. Revascularization was attempted
in one-third of cases and microsurgery was successful in 70% of cases. The
surgical amputation group consisted of 1132 patients with a mean age of 59 years,
while the replantation group consisted of 583 patients with a mean age of 48
years. The primary mechanism of injury was a table saw. DISCUSSION: This injury,
which must be addressed urgently, is not very common in everyday practice. This
is contrary to lower limb amputations, which are more common and occur in the
context of micro- and macroangiopathy in older patients. The success rate of
microsurgery in this cohort must be placed in the context of age, amputation
level and mechanism. The functional outcomes are not always as good as the
vascular outcomes. This data is invaluable as it fills a gap in our knowledge about amputations.
CI - Copyright (c) 2018. Published by Elsevier Masson SAS.

Langue : ANGLAIS

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