gms | German Medical Science

Objectives/Interrogation: To analyze the reasons for the failure of the upper arm replantation of avulsion injuries, summarized upper arm replantation's indications and improved the replantation methods.

Methods: 2014-1 ~ 2016-1, our department had treated 17 cases of upper arm torn off from trauma patients, two cases had been amputated in period I, the upper arms had been replanted in15 cases. Rapid debridement, simple and effective external fixation and internal fixation using microsurgical methods to repair blood vessels, nerves. Postoperation giving anti-inflammatory, anti-spasm, anticoagulation, rehydration and analgesic treatment, pay close attention to the blood supply situation.

Results and Conclusions: The postoperative patency rate: 100%, the incidence of skin necrosis: 73.3%; muscle necrosis rate: 80%; period II amputation rate: 20%; 1 case of upper arm torn off injuries replantation patients died; one case of postoperative acute renal failure, emergency amputation; one case after 10 days of discharge, hospital medication, muscle necrosis debridement rupture of blood vessels, amputation. Patients were followed up for 6-12 months, an average of 9 months. After 6 months of upper arm's function assessed according to the Chinese Medical Association limb amputated limb functional trial standards: The average score of 21.5 points, function deteriorated.

The upper arm torn off from traumatic injury for microsurgery is still a very difficult problem, without the forming upper extremity replantation guide, hemodynamic instability, multiple trauma, combined injuries are the high risk of replantation. From injury to the blood through needs a long time is the reason of surgical failure, period II amputation. Skilled microsurgical techniques can improve the successful rate of replantation.