TY - JOUR
T1 - Transhumeral amputation in brachial plexus lesion patients
T2 - A multicenter case series
AU - de Joode, Stijn G.C.J.
AU - Schotanus, Martijn G.M.
AU - Germawi, Lazin
AU - Westenberg, Ritsaart F.
AU - van Rhijn, Lodewijk W.
AU - Chen, Neal
AU - Samijo, Steven K.
N1 - Funding Information:
We thank Kiera Nyscha Lunn5 for making the collaboration between the Massachusetts General Hospital and Zuyderland Medical Center possible.
Publisher Copyright:
© 2022 Elsevier Masson SAS
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
KW - Complete brachial plexus lesion
KW - Elective amputation
KW - Flail limb
KW - Nonfunctional arm
KW - Transhumeral amputation
KW - Upper limb amputation
U2 - 10.1016/j.otsr.2022.103360
DO - 10.1016/j.otsr.2022.103360
M3 - Article
C2 - 35792322
SN - 1877-0568
VL - 109
JO - Orthopaedics & Traumatology-Surgery & Research
JF - Orthopaedics & Traumatology-Surgery & Research
IS - 5
M1 - 103360
ER -