The mangled extremity and attempt for limb salvage

<p>Abstract</p> <p>Background</p> <p>The decision, whether to amputate or reconstruct a mangled extremity remains the subject of extensive debate since multiple factors influence the decision.</p> <p>Methods</p> <p>Sixty three patients with high energy extremity trauma and attempts at limb salvage were retrospectively reviewed. We analyzed 10 cases of massive extremity trauma where there was made an attempt to salvage limbs, although there was a controversy between salvage and amputation.</p> <p>Results</p> <p>All of the patients except one had major vascular injury and ischemia requiring repair. Three patients died. All of the remaining patients were amputated within 15 days after the salvage procedure, mainly because of extremity sepsis. Seven patients required treatment at the intensive care unit. All patients had at least 2 reconstruction procedures and multiple surgical debridements.</p> <p>Conclusion</p> <p>The functional outcome should be considered realistically before a salvage decision making for extremities with indeterminate prognosis.</p

Surgical repair of the distal biceps brachii tendon: clinical and isokinetic long-term follow-up

Abstract Anatomical reinsertion of the avulsed distal biceps tendon is the recommended treatment, but the results are hampered by complications. The purpose of this study is to show the results of patients surgically treated with a non-anatomical reinsertion of this tendon. From 1972 to 2006, 26 non-professional athletic patients were surgically treated by suture of the tendon on the brachialis muscle tendon. At follow-up 23/26 patients underwent clinical and isokinetic evaluation. At a medium follow-up of 84 months, patients provided satisfactory subjective and objective clinical results. Flexion was restored in all patients, while a 10 degrees supination deficit was found in two patients. Dynamometric tests showed satisfactory results both regarding Maximum Strength Power and Endurance tests. Reinsertion of the distal biceps tendon on the brachialis tendon can be considered, in a long-term follow-up, a safe and effective procedure, with low complication rate