Arch Hand Microsurg.  2020 Jun;25(2):140-145. 10.12790/ahm.19.0057.

Successful Replantation after Amputation around Both Knee

• Ahn TY
• Kwak SH
• Kim DH
• Lee SH
• Park CI

• KMID: 2502711
• DOI: http://doi.org/10.12790/ahm.19.0057

Abstract

Reducing ischemic time is the most important factor associated with good results in major limb replantation. This case describes the surgery and outcome of replantation of both major limbs in a patient with amputation of both lower extremities due to rope entanglement on a ship. Emergency surgery restored circulation in 3 hours and 40 minutes after amputation on the left side, and 4 hours and 50 minutes after amputation on the right side. The left knee of the patient had undergone joint fusion and the right knee could move from 0 degree to 100 degrees. At present, the patient is able to walk using crutches. These results demonstrate that good results can be obtained if bilateral anastomosis is possible in both knees.

Keyword

Bilateral knee; Limb replantation; Ischemic time

Figure

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  Fig. 1. A 62-year-old male patient visited the hospital with amputation of both lower extremities due to rope entanglement on a ship.

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  Fig. 2. (A) Radiographs of the right knee after surgery showing the 5-cm shortening at the tibial proximal fracture of the femur fixed with a Steinmann pin. An external fixator was used. (B) Radiographs of left knee after surgery showing that the tibia proximal shaft fracture was removed by 5 cm and fixed with a Steinmann pin. An external fixator was used.

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  Fig. 3. Image 2 weeks after surgery showing necrosis around the left knee joint.

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  Fig. 4. (A) Image 2 years after surgery showing no problems with the appearance of the replanted parts. (B, C) Radiographs 2 years after surgery showing synostosis at the supracondylar fracture of the right femur and fixation of the left knee joint.

Reference

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