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At least 19 recordsLinked to original sources
PubMed2003

[Emergency reimplantation of the tongue after complete traumatic amputation].

Complete traumatic amputation of the tongue is very exceptional, the intra-oral position generally protecting the tongue. Most reported cases of trauma have involved partial section with satisfactory results after simple suture. Complete amputation of a portion of the tongue occurred in a 12-year-old boy during a fight. The fragment of the tongue was brought to the emergency unit. It was placed in heparinated saline solution and replanted successfully three hours after the trauma. Plastic surgery of the oral cavity was also performed to repair laceration injuries. The postoperative period was uneventful and the tongue regained vitality and normal motion. There was just a slight retraction. Replantation of the tongue after complete section may not be successful but should be attempted when possible.

Amputation, Traumatic↗
PubMed1994

Pattern of injury in those dying from traumatic amputation caused by bomb blast.

Traumatic amputation of limbs caused by bomb blast carries a high risk of mortality. This paper describes 73 amputations in 34 deaths from bomb blast in Northern Ireland. The principal aim was to determine the sites of traumatic amputation to provide a biophysical basis for the development of protective measures. Few amputations were through joints; nearly all were through the bone shafts. The most common site in the tibia was the upper third. The distribution of femoral sites resulting from car bombs differed from that characterizing other types of explosion. For car bombs the principal site of amputation was the upper third; for other types of device it was the lower third. It is concluded that flailing is not a notable contributor to limb avulsion. The pattern of amputation is consistent with direct local pressure loads leading to bone fracture; the amputation itself is a secondary event arising from the flow of combustion products.

Amputation, Traumatic↗
PubMed1993

[Traumatic amputation of the lower limb and traumatic hemipelvectomy. Report of 2 cases in children and review of the literature].

Traumatic hemipelvectomy is rarely observed, mostly because very few patients survive the initial trauma. We describe 2 cases of children who survived this trauma. The first was a 12 year-old boy who accidentally fell between a metro train and the platform. He had a severe open trauma of the pelvis with important hemorrhage. After a first operation to stop hemorrhage and do a cystotomy and a colostomy, ischemia of the lower limb led to an inter-ilio-abdominal amputation. Two months were necessary to heal this. A prosthesis was made 12 months after the accident, postponed by urinary problems. The boy also had a traumatic amputation of the left arm and an upper metaphyseal fracture of the humerus. The second case was that of an 8 year-old girl who suffered a complete traumatic amputation of the hemipelvis after a road accident. A secondary colostomy was performed because of a local infection. Once healing was achieved, the child was low to follow-up. In the literature, we found 36 survivors to this dreadful lesion (4 of them children). We analysed the different problems for the treatment of this trauma caused, and their short term consequences. An early evaluation of the lesions, rapid and intensive resuscitation, early decision to complete the traumatic amputation if necessary, with urinary and digestive derivation, are important elements towards eventual successful outcome of the treatment.

Amputation, Traumatic↗
PubMed1995

[Elongation and coverage of an inguinal flap over a short forearm traumatic amputation stump].

A particularly short traumatic amputated forearm finally led to a simplified under-elbow prosthesis after a long surgical program including: 1) A progressive 8 cm ulnar lengthening with a Wagner device; 2) and a secondary groin flap resurfacing the distal stump. Complications essentially concerned the ulnar lengthening particularly because of a weak osseous callus. Final aesthetic and functional results are satisfying with a 6 years follow-up.

Adult↗
PubMed1990

Traumatic amputation. Mechanisms of injury, treatment, and rehabilitation.

Traumatic amputations are one of many injuries that can occur to the body's musculoskeletal systems. Degloving, partial and total amputations are common types of traumatic injuries. Since traumatic amputations are very life threatening, emergency treatment must be initiated quickly and directed toward profuse blood loss and potential hypovolemia. Not only do traumatic amputees undergo extreme physiological changes, but they must also encounter the psychological trauma of an amputation. Due to a loss of body part(s) and alteration in body image, the amputee often experiences the stages of grieving which may take months and years to resolve. Extensive rehabilitation with the use of an interdisciplinary team approach is one of the most successful ways to return the amputee to the work place. A combination of occupational therapy, physical therapy, vocational rehabilitation and psychological support generally promote a sense of well being and return the traumatic amputee to a level of independence.

Accidents, Occupational↗
PubMed2004

Demographics of traumatic amputations in children. Implications for prevention strategies.

BACKGROUND: The demographics of traumatic amputations in children are not well known. The purpose of this review was to identify those demographics for use as a possible guide for prevention strategies. METHODS: The study was a retrospective review of the data on children with traumatic amputation who had received care at one center in the upper midwestern United States from 1980 to 2000. The child's gender and age at the time of the amputation, the date and etiology of the amputation, and the amputation level were tabulated. Statistical analyses of seasonal variations were performed. RESULTS: There were 256 amputations in 235 children. The mean age (and standard deviation) at the time of the amputation was 7.9 +/- 5.0 years. The amputation involved one extremity in 217 children, two extremities in sixteen, and three and four extremities in one child each. Of the 256 amputations, 165 involved the lower extremity. The traumatic amputation was caused by a lawnmower in sixty-nine children, farm machinery in fifty-seven, a motor-vehicle accident in thirty-eight, a train in twenty, and miscellaneous mechanisms in fifty-one. The mean age at the time of the injury varied according to the mechanism of injury and ranged from 1.9 years for burns to 11.5 years for boating injuries. Fifty-four (78%) of the sixty-nine children with a lawnmower amputation were five years of age or less. There were significant seasonal variations: the mean date of the lawnmower injuries was June 10, the mean date of the farming injuries was September 2, and the mean date of the motor-vehicle-related injuries was July 16. CONCLUSIONS: There are common patterns of traumatic amputations in children based on the mechanism of injury, the season, and the age of the child. The ideal time for an educational campaign for the prevention of lawnmower injuries appears to be March and April and should be directed toward parents. The best times for such a campaign for the prevention of farming-related accidents appear to be both the spring and the early fall, and the campaign should be directed toward both parents and older children.

Adolescent↗
PubMed1992

Traumatic amputation by explosive blast: pattern of injury in survivors.

Explosive blast causes a pattern of injury including primary blast lung, secondary fragment injury and traumatic amputation of limbs. Major traumatic amputation is rare in survivors of bomb blast but common in those who die. The mechanism of such injury has not been previously determined, but must be established if protective measures are to be developed for members of the armed forces. The nature of 41 traumatic amputations in 29 servicemen who survived to reach medical care after blast injury was investigated to determine the anatomical level of amputation and the pattern of soft tissue damage. Joints were an infrequent site of amputation and the tibial tuberosity was a particularly frequent site of lower-limb severance. Comparison of the pattern of injury was made with that seen in ejecting fast-jet pilots, who frequently suffer major flailing injury; there appears to be a substantially different injury distribution. The accepted mechanism of traumatic amputation, avulsion by the dynamic overpressure, is challenged; it is suggested that the shockwave resulting from an explosion is capable of causing at least bone disruption in a limb.

Amputation, Traumatic↗
PubMed1996

Pattern and mechanism of traumatic amputation by explosive blast.

The mechanism of traumatic amputation of limbs by explosion is presented. A survey of blast casualties from Northern Ireland revealed that amputations through joints were very uncommon--the principal site was through the shaft of the long bones. Computer modelling of a bone exposed to blast forces reinforced the hypothesis developed from the casualty survey, that the primary mechanism of the bone injury was the direct coupling of the blast wave into the tissues. The fracture occurs from the resulting axial stresses in the bone, prior to limb flailing from the gas flow over the limb. The gas flow completes the amputation. Field trials employing a goat hind limb model have confirmed the hypothesis. Having identified the mechanism, concepts to develop protective clothing may now be proposed.

Amputation, Traumatic↗
PubMed1978

Phantom limbs and related phenomena in recent traumatic amputations.

Seventy-three soldiers who had traumatic amputations were examined from 1 to 6 months after limb loss. All experienced phantom limb sensations and 67 percent experienced phantom limb pains, usually transient. Stump pain occurred in 43 percent and was associated with phantom pain in 54 percent of these. Of the 23 percent of the entire group who had evident stump pathology, 33 percent had phantom pains only, 20 percent had stump pains only, 40 percent had both, and 7 percent were pain-free. All stump ends exhibited an area of hyperpathia with hypoesthesia. Phantom pain probably results from peripheral or spinal cord mechanisms, or both, rather then from more rostral mechanisms.

Adult↗
PubMed2005

Characteristics of pediatric traumatic amputations treated in hospital emergency departments: United States, 1990-2002.

OBJECTIVE: To examine the characteristics of children with traumatic amputations and the products associated with these injuries. METHODS: Data regarding amputation injuries to children younger than 18 years treated in US emergency departments from 1990 to 2002 were obtained from the National Electronic Injury Surveillance System. Data included demographics, product involved, and body region injured. RESULTS: An estimated 111,600 children younger than 18 years with amputation injuries were treated in US emergency departments from 1990 to 2002. The average age was 6.18 years (median: 4 years; mode: 1 year old). Males experienced 65.5% of these injuries. Finger amputations accounted for 91.6% of all amputations, ranging from 95.2% among 0- to 2-year-olds to 87.9% among 13- to 17-year-olds. Complete amputations accounted for 70.2% of all amputations among 13- to 17-year-olds compared with 52.6% of amputations among 0- to 2-year-olds. Adolescents also had the highest proportion of amputations resulting in hospital admission (26.6% for 13- to 17-year-olds compared with 11.9% for 0- to 2-year-olds). Adolescents had the highest proportion of amputation injuries involving lawn mowers (14.1% for 13- to 17-year-olds compared with 1.4% for 0- to 2-year-olds) and the highest proportion of amputations involving tools (29.3% for 13- to 17-year-olds compared with 2.5% for 0- to 2-year-olds). The percentage of amputations involving doors peaked in the youngest age group and decreased as age increased (65.8% of all amputations for 0- to 2-year-olds compared with 14.1% for 13- to 17-year-olds). CONCLUSIONS: To our knowledge, this is the first study to use a nationally representative sample to broadly investigate amputation injuries among children. The majority of traumatic amputation injuries occur to young children, to males, and to fingers and the majority involve doors. Adolescents experience a higher proportion of more serious amputation injuries. Effective interventions exist but are inadequately used to prevent many of these injuries, including door stops and modifications, bicycle-chain and spoke guards, wearing closed-toe footwear while bicycling, a no-mow-in-reverse default feature on ride-on lawnmowers with the override switch located behind the mower operator, and a SawStop system on power saws. Use of these technical countermeasures and changes in relevant product standards to promote their implementation and use could lead to a decrease in pediatric traumatic amputations.

Accident Prevention↗
PubMedDate not supplied

Emergency intervention in traumatic amputation.

This article focuses on emergency management of traumatic amputation. Emphasis is given to the initial intervention and treatment of the victim and care of the amputated part.

Amputation, Traumatic↗
PubMed1992

[Not a tourniquet, but compressive dressing. Experience from 68 traumatic amputations after injuries from mines].

In autumn 1991, 68 patients with traumatic amputations after injuries caused by mines were evacuated to the United Nation's field hospital in the demilitarized zone between Iraq and Kuwait. Most were seen during a three week period when civilians harvested mines. During the first days of this period, continuous bleeding distally to applied tourniquets was frequently observed. Orders were issued to remove any tourniquets and cover the wounds with a very tight elastic bandage. Prehospital intravenous infusions were decreased. Three out of 18 patients died prior to the change of routine compared with one out of 50 afterwards. The new directives led to visibly less haemorrhage. Haemoglobin on admission was mean 8.6 g/100 ml during the first part of the observation period compared with mean 10.5 g/100 ml with the new routine. 23 patients received blood transfusions. Fewer patients needed transfusions after the use of tourniquets was discontinued. A tourniquet should not be used in the treatment of bleeding extremity injuries. In extensive crush injuries and traumatic amputations a compressive dressing should be used, applied from the end of the extremity in a proximal direction.

Adult↗
PubMed1988

Chylothorax following traumatic amputation of upper arm.

A young patient who had traumatic amputation of left arm developed extensive chylothorax on right side of chest. The pathophysiology appears to be left subclavian thrombosis secondary to gross sepsis of the amputation stump which resulted in occlusion of thoracic duct opening and chylothorax. The child was successfully treated by closed chest tube drainage.

Amputation, Traumatic↗
PubMed2004

[Lengthening of the phalanges by callus distraction in traumatic amputations of the fingers].

OBJECTIVES: We evaluated the results of lengthening of the phalanges by callus distraction in traumatic amputations of the fingers. METHODS: We treated traumatic amputations of 16 fingers of 13 male patients (mean age 27.7 years; range 12 to 43 years) by callotasis of the phalanges. Callus distraction was performed with a rate of 1 mm/day using a unilateral dynamic external fixation device. The mean follow-up period was 42 months (range 12 to 80 months). RESULTS: The mean lengthening was 24 mm (range 18 to 26 mm) and 21 mm (range 18 to 26 mm) for the thumbs and the other fingers, respectively. The achieved thumb length provided adequate depth and width of the first web space and enabled functional improvement in the ability of gripping, and pulp-to-pulp and pulp-to-side pinching. In the absence of flexor pollicis longus, the mean strength of the thumbs was 7 kg (range 5 to 9 kg), amounting to 65% of the normal side. Lengthening of the other fingers resulted in improved functioning of the hand. The mean healing index (number of months per centimetre of lengthening) was 1.7 months/cm (range 1.6 to 2.1 months/cm) and 1.6 months/cm (range 1.4 to 1.9 months/cm) in the thumbs and the other fingers, respectively. Pin tract infections were observed in four phalanges. CONCLUSION: Callotasis of the proximal phalanx of the thumb is an effective reconstruction method to compensate for the loss of distal phalanx and to alleviate functional problems due to shortness. It may also be applied to the phalanges of the other fingers in patients who do not accept ray resection with or without transposition.

Adolescent↗
PubMed1999

[Heterotopic replantation of fingers after traumatic amputation].

Available are the results of the treatment of 93 patients with multiple traumatic amputations of the fingers, in whom the heterotopic digital replantation was carried out. A total of 367 fingers were amputated, 187 of them have been replanted, which made up 51% of replantability. 148 fingers (79.1%) were replanted heterotopically and 39 (20.9%)--orthotopically. The viability was restored in 167 fingers, which made up 89.3%. Of 148 fingers, which have been replanted heterotopically, 88.6% have survived, and of 39 fingers, being replanted orthotopically, 92.4% survived. The analysis of functional results of the digital replantations in hand comprised the study of the hand biomechanics, blood supply and innervation. A total of 31 patients was followed up and examined in long term period from 8 months to 6 years after replantation. The biomechanics of the hand was assessed according to its capacities for seize and pinch as well as to the extent of movements in the joints of the restoration of digital innervation was assessed by the study of temperature and discrimination sensitivity. For evaluation of blood supply the US dopplerography and scintigraphy were used. The authors came to the conclusion that there was no substantial difference in the function of operated fingers both in orthotopic and heterotopic replantations. Taking into account that heterotopic replantation of the fingers resulted in more active digital function, it is safe to speak about more pronounced increase in the function of the hand in cases of heterotopic replantations of fingers in their multiple traumatic amputation.

Adolescent↗
PubMed1986

Traumatic amputations in the workplace.

The purpose of this study was to identify variables associated with traumatic amputations in the workplace. Case files of work-related amputations in Minnesota during 1977 were accessed in cooperation with the Workers' Compensation Division of Minnesota. Data analysis was conducted by computer using the Statistical Package for Social Sciences. Of the 109 amputation cases, a mean age of 31 years (range 16 to 80) was identified; 50% of all cases were below the age of 25 years. By gender, males accounted for five times as many cases as females. Operatives incurred the largest number of amputations (40%); yet, they account for only 14% of the total work force. Manufacturing accounted for a majority (43.4%) of the traumatic amputations while including only 18 percent of the work force. Prevention strategies employed subsequent to the injuries included: training only (32.1%), engineering controls (10.1%), and mixed strategies (3.0%); further analysis revealed that although application of passive controls to the specific source (eg, machine) of the injury would have been most appropriate, training was frequently the only intervention incorporated. Recommendations, including Haddon's strategies for prevention and control of amputations are presented.

Accidents, Occupational↗