Replantation of traumatic limb amputation above the elbow: a report of 4 cases

Traumatic amputation of upper limb above the level of the elbow، are rare injuries that a surgeon may be faced with a handful of cases during his career. Even with advanced techniques in microvascular surgery، the survival of the transplanted limb that cut off completely from the arm is relatively weak. Four injured people (patient) in Imam Khomeini Hospital during 1999-2013 in Tehran University of Medical Sciences were treated. Two patients had complete amputation of limb and other patients suffered from complete cutting in artery and vein along with neurological and soft tissue damages. There was not any ischemia or gangrene. However، efficiency of limbs with damages in peripheral nerves was not significant. The main reason was lack of immediate repair of the damaged nerves. In the recent examination، after discharge، the performance of the limb is firstly related to the conditions of the nerve system and secondly it depends on the severity of the injury in each of the muscles. However، none of the patients were dissatisfied of any situation and they were prepared to make any cooperation for improving the condition of their transplanted limb. Transplantation of the amputated limb can be done in spite of limited resources. Any delay in repairing damaged nerves will result great reduction of final organs’ performance. A limb، made from the own body، always take precedence to prosthesis، even when the efficiency is low.