بتر الطرف العلوي - Upper Limb Amputation - البروفيسور فريح...

11/7/2014Professor Freih Abuhassan -

University of Jordan 1

Hand amputation

11/7/2014 2Professor Freih Abuhassan -

University of Jordan

= Black parts are most important to preserve,

= Oblique lines indicate less important parts,

= White areas are troublesome and should be amputated. 11/7/2014 4

Professor Freih Abuhassan -


In amputations of many digits,

pinch and grasp are the chief

functions to be preserved



1-The amount of skin lost,

2- The depth of the soft tissue defect,

and whether the phalanx has been exposed

or even partially amputated



KUTLER V-Y ADVANCEMENT FLAPS



ATASOY ADVANCEMENT FLAPS



CROSS FINGER FLAPS



THENAR FLAP



LOCAL N.V ISLAND GRAFT



at PIPJ= at a more proximal level the remaining

stump is useless and may hinder pinch

between the thumb and middle finger.

= decrease grip by 20%

= loss of precision handling skills

= control of hammers is decreased



The prox. phalanx is import. functionally

Its absence

1- makes a hole through which small objects

can drop when the hand is used as a cup

or in a scooping maneuver.

2-makes the remaining fingers tend to

deviate toward the midline of the hand.



At least length of proximal phalanx

& ½ middle phalanx needed to be

preserved, otherwise entire digit

removed.

In ThumbAny amount of length preserved.



Thumb reconstruction at various levels.



Osteoplastic reconstruction of thumb.



Preferred over BE operation as

pronation & supination preserved.



As much preservation

as possible - not < 5 cm.



End of humerus can be gripped by

prosthesis - advantage.



Level should be below level of axillary

fold & proximal at least 5 cm to elbow

(to allow prosthesis fitting).



A/Elbow



Head preserved to maintain

contour of shoulder.



Removal of UL with clavicle, scapula

& related muscles.

(inter-scapulo-thoracic amputation)



11/7/2014 39

Professor Freih Abuhassan -


بتر الطرف العلوي - Upper Limb Amputation - البروفيسور فريح...

Health & Medicine

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