The salvage of upper limbs mangled by industrial machinery became possible with the development of predictable techniques of vascular and microvascular anastamosis.
Unfortunately, many of these salvaged limbs are associated with fair and poor functional out-comes.
The quality of the skeletal fixation can have substantial effect on the functional outcome and should be a major focus of the limb repair process.
Internal plate fixation facilitates wound care and limb mobilization without tethering muscle-tendon units and is safe in the majority of severe upper limb injuries provided that all devitalized tissue is debrided and, if necessary, reconstructed using microvascular tissue transfers.
Injury patterns, especially those which involve associated injury of the elbow or forearm ligaments, must be identified and treated appropriately.
Internal fixation should restore anatomical alignment and provide sufficient stability to allow immediate active mobilization of the limb ithout contributing to devascularization of the soft tissues or skeleton.
Mots-clés Pascal : Amputation, Membre inférieur, Industrie, Vaisseau sanguin, Fracture ouverte, Partie molle, Reconstruction anatomique, Anastomose chirurgicale, Médecine travail, Technique, Traitement, Pronostic, Homme, Os, Système ostéoarticulaire pathologie, Traumatisme, Vaisseau sanguin pathologie, Appareil circulatoire pathologie, Peau pathologie, Chirurgie orthopédique, Mutilation
Mots-clés Pascal anglais : Amputation, Lower limb, Industry, Blood vessel, Open fracture, Soft tissue, Anatomical reconstruction, Surgical anastomosis, Occupational medicine, Technique, Treatment, Prognosis, Human, Bone, Diseases of the osteoarticular system, Trauma, Vascular disease, Cardiovascular disease, Skin disease, Orthopedic surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0491772
Code Inist : 002B16H. Création : 22/03/2000.