Transhumeral amputation in brachial plexus lesion patients: A multicenter case series.
Complete brachial plexus lesion
Elective amputation
Flail limb
Nonfunctional arm
Transhumeral amputation
Upper limb amputation
Journal
Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
31
08
2021
revised:
07
04
2022
accepted:
29
06
2022
medline:
22
8
2023
pubmed:
7
7
2022
entrez:
6
7
2022
Statut:
ppublish
Résumé
A flail limb can be the result of a traumatic complete brachial plexus lesion. Some patients prefer retaining the flail limb, however some patients feel that a flail limb negatively affects daily life. In these circumstances an elective amputation is sometimes elected, however long-term follow-up, with respect to satisfaction and function is unknown. The aim of this study is to evaluate the long-term outcome of this rare and life changing operation. 8 patients with a transhumeral amputation performed in 2 specialized medical centers were included. Postoperatively, the functional- and psychological outcome and the quality of life were evaluated with standardized patient reported outcome measures (PROMs; DASH, SIP-68, EQ-5D-5L and HADS). After a median of 9.4 (range 7.5 - 12.8) years follow-up, 7 patients (88%) stated that they would undergo the operation again and were satisfied with the results. At latest follow-up the median DASH score was 37.3 (range 8.3-61.7), the median SIP-68 score was 6.5 (range 0-43) and the median HADS score was 3.0 (range 0-14) for anxiety and 3.0 (range 1-19) for depression. In the EQ-5D-5L patients had most difficulties in self-care, usual activities and pain/discomfort. The median overall health status was 69 (range 20-95). With the right indication a transhumeral amputation is a reasonable option for traumatic complete brachial plexus lesion with satisfying long-term results. IV, multicenter case series.
Sections du résumé
BACKGROUND
A flail limb can be the result of a traumatic complete brachial plexus lesion. Some patients prefer retaining the flail limb, however some patients feel that a flail limb negatively affects daily life. In these circumstances an elective amputation is sometimes elected, however long-term follow-up, with respect to satisfaction and function is unknown. The aim of this study is to evaluate the long-term outcome of this rare and life changing operation.
MATERIALS AND METHODS
8 patients with a transhumeral amputation performed in 2 specialized medical centers were included. Postoperatively, the functional- and psychological outcome and the quality of life were evaluated with standardized patient reported outcome measures (PROMs; DASH, SIP-68, EQ-5D-5L and HADS).
RESULTS
After a median of 9.4 (range 7.5 - 12.8) years follow-up, 7 patients (88%) stated that they would undergo the operation again and were satisfied with the results. At latest follow-up the median DASH score was 37.3 (range 8.3-61.7), the median SIP-68 score was 6.5 (range 0-43) and the median HADS score was 3.0 (range 0-14) for anxiety and 3.0 (range 1-19) for depression. In the EQ-5D-5L patients had most difficulties in self-care, usual activities and pain/discomfort. The median overall health status was 69 (range 20-95).
DISCUSSION
With the right indication a transhumeral amputation is a reasonable option for traumatic complete brachial plexus lesion with satisfying long-term results.
LEVEL OF EVIDENCE
IV, multicenter case series.
Identifiants
pubmed: 35792322
pii: S1877-0568(22)00187-6
doi: 10.1016/j.otsr.2022.103360
pii:
doi:
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103360Informations de copyright
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