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Sci Rep 2022 Jun 17;12(1):10218. Epub 2022 Jun 17.

Center for Bionics and Pain Research, Mölndal, Sweden.

Robotic prostheses controlled by myoelectric signals can restore limited but important hand function in individuals with upper limb amputation. The lack of individual finger control highlights the yet insurmountable gap to fully replacing a biological hand. Implanted electrodes around severed nerves have been used to elicit sensations perceived as arising from the missing limb, but using such extra-neural electrodes to record motor signals that allow for the decoding of phantom movements has remained elusive. Read More

Hand Surg Rehabil 2022 06 10;41(3):391-399. Epub 2022 Mar 10.

Department of Clinical Research, King Hussein Cancer Center, Queen Rania Al Abdulla St. 202, 11941 Amman, Jordan.

Chemotherapy extravasation can cause severe harm. There is a lack of evidence-based standardization on the surgical management of such injuries beyond the immediate stage. In an algorithm connecting presentation time post-injury with surgical treatment could help standardize future treatment. Read More

Clin Orthop Relat Res 2022 06 23;480(6):1191-1204. Epub 2022 Feb 23.

Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria.

Background: Currently used prosthetic solutions in upper extremity amputation have limited functionality, owing to low information transfer rates of neuromuscular interfacing. Although surgical innovations have expanded the functional potential of the residual limb, available interfaces are inefficacious in translating this potential into improved prosthetic control. There is currently no implantable solution for functional interfacing in extremity amputation which offers long-term stability, high information transfer rates, and is applicable for all levels of limb loss. Read More

Clin Shoulder Elb 2021 Dec 1;24(4):245-252. Epub 2021 Dec 1.

Orthopedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: In patients with total elbow arthroplasty (TEA), the soft-tissue around the elbow can be vulnerable to soft-tissue complications. This study aims to assess the outcomes after soft-tissue reconstruction following TEA.

Methods: We retrospectively included nine adult patients who underwent soft-tissue reconstruction following TEA. Read More

Jpn J Clin Oncol 2022 Feb;52(2):157-162

Department of Orthopaedic Surgery, Nagoya University Hospital, Nagoya, Japan.

Background: Soft tissue sarcomas are a diverse group of rare malignant tumours, mostly occurring in the lower extremities. Amputations are necessary for achieving local control when the soft tissue sarcomas are too large and/or have neurovascular involvement. Patients who require amputation have a poorer prognosis than those who undergo limb-salvage surgery. Read More

J Vis Exp 2021 10 29(176). Epub 2021 Oct 29.

Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna; Department of Plastic and Reconstructive Surgery, Medical University of Vienna;

Targeted Muscle Reinnervation (TMR) improves the biological control interface for myoelectric prostheses after above-elbow amputation. Selective activation of muscle units is made possible by surgically re-routing nerves, yielding a high number of independent myoelectric control signals. However, this intervention requires careful patient selection and specific rehabilitation therapy. Read More

J Endovasc Ther 2022 06 8;29(3):468-477. Epub 2021 Oct 8.

Division of Interventional Radiology, University Health Network, Toronto, ON, Canada.

Purpose: To perform a systematic review assessing the safety and efficacy of percutaneous transluminal angioplasty (PTA) for treatment of critical hand ischemia (CHI) due to below-the-elbow (BTE) obstructive arterial disease.

Materials And Methods: MEDLINE and EMBASE systematic searches were performed from inception to December 2020 to identify studies assessing PTA for management of BTE obstructive arterial disease. Three independent reviewers performed abstract selection, data extraction, and quality assessment. Read More

Arch Rehabil Res Clin Transl 2021 Sep 24;3(3):100148. Epub 2021 Jul 24.

Center for Devices and Radiological Health, Office of Science and Engineering Labs, United States Food and Drug Administration, Silver Spring, MD.

Objective: To understand how perceived function relates to actual function at a specific stage in the rehabilitation process for the population using upper limb prostheses.

Design: Quantitative clinical descriptive study.

Setting: Clinical offices. Read More

J Burn Care Res 2022 May;43(3):704-709

Department of General Surgery, Burn Center, University of Health Sciences, Adana City Training and Research Hospital, Turkey.

Although electrical injuries (EIs) are rare traumas in the pediatric age group, they are considered one of the most devastating injuries. We aimed to evaluate the patterns and outcomes of pediatric high-voltage injuries (HVIs) vs low-voltage injuries (LVIs), admitted to the burn center within the efforts of determining evidence-based data for contributing to burn prevention strategies. A retrospective study was conducted on children with EIs hospitalized in the Burn Center of Adana City Training and Research Hospital for 8 years (2013-2020). Read More

J Neural Eng 2021 09 23;18(5). Epub 2021 Sep 23.

UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, The Netherlands.

The sensorimotor cortex is often selected as target in the development of a Brain-Computer Interface, as activation patterns from this region can be robustly decoded to discriminate between different movements the user executes. Up until recently, such BCIs were primarily based on activity in the contralateral hemisphere, where decoding movements still works even years after denervation. However, there is increasing evidence for a role of the sensorimotor cortex in controlling the ipsilateral body. Read More

Am J Phys Med Rehabil 2022 06 4;101(6):545-554. Epub 2021 Aug 4.

From the Research Department, Providence VA Medical Center, Providence, Rhode Island (LR, MB); Health Services, Policy and Practice, Brown University, Providence, Rhode Island (LR); US Army Burn Center, US Army Institute of Surgical Research, Ft. Sam Houston, Texas (JC); Physical Medicine and Rehabilitation Services, James A. Haley Veterans' Hospital & Clinics, Tampa, Florida (JH); Physical Medicine and Rehabilitation Department, University of South Florida, Tampa, Florida (JH); Rehabilitation & Prosthetic Services (10P4R), Orthotic, Prosthetic & Pedorthic Clinical Services, US Department of Veterans Affairs, Washington, DC (MJH); School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, Tampa, Florida (MJH); Physical Medicine and Rehabilitation Service, North Florida/South Georgia Veterans Health System, Gainesville, Florida (CL); James A. Haley VA Hospital, Tampa, Florida (SP); Department of Physical Medicine and Rehabilitation, School of Medicine at Virginia Commonwealth University, Richmond, Virginia (JW); and Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia (JW).

Objective: The aim of the study was to describe and quantify the relationship between limb impairment variables to key functional outcomes.

Design: This was an observational study of 107 participants with unilateral above/at-elbow or below-elbow/wrist amputation. Demographics, prosthesis characteristics, residual limb length, and prevalence of passive range-of-motion restrictions, and strength impairments were described. Read More

J Hand Ther 2021 May 16. Epub 2021 May 16.

Extremity Trauma and Amputation Center of Excellence, JBSA Fort Sam Houston, TX 78234, USA; Axiom Resource Management, Inc., San Diego, CA, USA.

Study Design: Retrospective cohort study INTRODUCTION: Service members who have sustained traumatic amputations are typically young and otherwise healthy. Beyond standard care, these individuals desire long, highly active, and relatively pain-free lifestyle, whether that is returning to active duty or transitioning to civilian life. Development of overuse musculoskeletal conditions could have a significant influence on quality of life for Service members with traumatic upper limb amputation. Read More

Ann Vasc Surg 2021 Oct 25;76:289-292. Epub 2021 Jun 25.

Department of Clinical and Molecular Medicine, ``Sapienza'' University of Rome, Italy; Vascular and Endovascular Surgery Division, Sant'Andrea Hospital of Rome, Italy.

To describe the case of a young female patient, affected by Systemic Lupus Erythematous, hospitalized for severe SARS-CoV-2 infection pneumonia and presenting a treatment-resistant acute upper limb ischemia. Two days after hospital admission, the patient suffered sudden right upper limb pain associated with mild functional impairment. At physical examination, radial and ulnar pulses were absent, and no flow signal was detected at duplex ultrasound scan. Read More

Cureus 2021 Apr 27;13(4):e14721. Epub 2021 Apr 27.

Orthopedics and Traumatology, Kayseri City Hospital, Kayseri, TUR.

Coronavirus disease of 2019 (COVID-19), caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in Wuhan, was declared a pandemic by the World Health Organization. COVID-19 has many different clinical manifestations. One of them is arterial hypercoagulopathy. Read More

Microsurgery 2021 Sep 17;41(6):562-568. Epub 2021 Apr 17.

Akdeniz University Faculty of Medicine, Antalya, Turkey.

Although there have been numerous reports of major replantation of upper extremity amputations, limited numbers of above-elbow amputation replantation have been reported. We present the technical details of two successful replantations of forequarter amputations in a nine-year-old girl and a three-year-old boy. In both cases, the forequarter was amputated due to avulsion traction injuries resulting in amputation including the entire upper limb, while the integrity of the scapula and parascapular muscles was maintained, with no injury to the glenohumeral joint. Read More

Int J Surg Case Rep 2021 Feb 28;79:479-483. Epub 2021 Jan 28.

Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore. Electronic address:

Introduction: Acute type A aortic dissection (AAAD) is a surgical emergency with high operative mortality. Distal propogration of the dissecting flap can lead to malperfusion of territory supplied by the aorta including axillary and brachial arteries causing ischaemia of the upper limb.

Case Presentation: We present a case of a 67 year old gentleman who had AAAD and developed upper limb malperfusion after repair. Read More

Hand (N Y) 2021 11 17;16(6):NP15-NP18. Epub 2021 Feb 17.

Medical College of Wisconsin, Milwaukee, USA.

Targeted muscle reinnervation (TMR) has been shown to improve phantom and neuropathic pain in both the acute and chronic amputee population. Through rerouting of major peripheral nerves into a newly denervated muscle, TMR harnesses the plasticity of the brain, helping to revert the sensory cortex back toward the preinsult state, effectively reducing pain. We highlight a unique case of an above-elbow amputee for sarcoma who was initially treated with successful transhumeral TMR. Read More

BMJ Case Rep 2021 Jan 26;14(1). Epub 2021 Jan 26.

General Surgery, Amrita School of Medicine, Amrita Viswavidyapeetham, Kochi, India.

Novel COVID-19 continues to intrigue medical professionals with its varied presentations. Though it affects the respiratory tract primarily, thrombogenesis has been the Achilles' heel. A 44-year-old man diagnosed with COVID-19 presented with upper limb pain at a local hospital and was found to have thrombosis of the right axillary artery. Read More

Niger Med J 2020 Sep-Oct;61(5):288-290. Epub 2020 Oct 13.

Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Nigeria.

The term "sideswipe injury" has become synonymous and used interchangeably with the term "traffic elbow." However, with the continuous rise in the use of the tricycle as a means of public transportation in some developing countries, a rise in sideswipe injuries of various severities is being experienced. We report a case of sideswipe injury to the left knee region of a 45-year-old female who was a passenger in the backseat of a tricycle. Read More

Int J Surg Case Rep 2020 19;77:618-623. Epub 2020 Nov 19.

DDRC SRL, Trivandrum, India.

Introduction: We present a rare case of Malignant Peripheral Nerve Sheath Tumour (MPNST) of the upper limb, which was excised thirteen times in thirteen years and ultimately ended in above elbow amputation.

Presenting Complaint And Investigations: A 48 year old female presented initially with a localised swelling of 2 cms diameter in the front of the left elbow in 2007, which was excised. It recurred repeatedly and was excised. Read More

Cureus 2020 Jul 7;12(7):e9051. Epub 2020 Jul 7.

Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND.

A 22-year-old female presented with painful, progressive swelling of the right forearm for six months. Physical examination revealed a 7 cm x 5 cm firm, tender soft-tissue swelling over the anterior aspect of the right proximal forearm with normal overlying temperature. X-rays showed increased soft tissue shadow but without any bony involvement. Read More

J Burn Care Res 2020 11;41(6):1304-1305

General Surgery, St. John's Medical College, Bengaluru, India.

Electrical injuries are among the most devastating of burn injuries. High-voltage electrical injuries result in extensive deep tissue damage and are associated with multiple complications, long-term morbidity, and a high mortality rate. We describe the case of a 16-year-old male cable operator who suffered high-voltage electric injury of left upper limb and anterior abdominal wall. Read More

Ortop Traumatol Rehabil 2020 Apr;22(2):85-93

University Rehabilitation Institute, Linhartova Ljubljana, Slovenia.

Background: There is a lack of studies on adjustment to upper limb prosthesis with large representative samples that would compare different prosthesis types and use standardised outcome measures. Hence, we wanted to assess satisfaction with, and level of adjustment to, an upper-limb prosthesis among people after an upper limb amputation in our country.

Material And Methods: We conducted a cross-sectional descriptive study. Read More

Cureus 2020 Feb 1;12(2):e6842. Epub 2020 Feb 1.

Internal Medicine, Fatima Jinnah Medical University, Lahore, PAK.

Subclavian artery thrombosis is a rare cause of upper limb ischemia resulting from occlusion of the upper extremity blood supply. Symptomatic presentation is quite rare and therefore remains underdiagnosed by physicians. Possible catastrophic clinical consequences necessitate prompt rectification of the underlying disease and risk factors. Read More

Malawi Med J 2019 12;31(4):244-248

Department of Surgery, University of North Carolina at Chapel Hill, USA.

Introduction: Amputations in low- and middle-income countries (LMICs) represent an important cause of disability and economic hardship. LMIC patients are young and suffer from preventable causes, such as trauma and trauma-related infections. We herein studied the etiology in amputations in a Malawian tertiary care hospital over a 9-year period. Read More

J Clin Med 2019 Dec 20;9(1). Epub 2019 Dec 20.

Clinical Laboratory for Bionic Extremity Reconstruction, Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.

Global brachial plexopathies including multiple nerve root avulsions may result in complete upper limb paralysis despite surgical treatment. Bionic reconstruction, which includes the elective amputation of the functionless hand and its replacement with a mechatronic device, has been described for the transradial level. Here, we present for the first time that patients with global brachial plexus avulsion injuries and lack of biological shoulder and elbow function benefit from above-elbow amputation and prosthetic rehabilitation. Read More

J Rehabil Med Clin Commun 2019 17;2:1000025. Epub 2019 Dec 17.

Service de MPR-HIA Laveran, Marseille Cedex, France.

Background: Creating a custom prosthetic device is challenging. The requirements of the patient's life must be taken into consideration when manufacturing the device. After having met the requirements for an autonomous daily life, adjustments can be made for recreational activities. Read More

Ann Afr Med 2019 Oct-Dec;18(4):196-199

Department of Surgery, John F. Kennedy Memorial Hospital, Monrovia, Liberia.

Background: Amputation is one of the oldest known surgical procedures. It has been one of the modalities of applying judgment and treatment. Its method and indications has evolved over time. Read More

Plast Reconstr Surg 2019 12;144(6):1037e-1043e

From the Division of Plastic and Reconstructive Surgery and the Christian Doppler Laboratory for Restoration of Extremity Function, Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Department of Physical Medicine and Rehabilitation, Medical University of Vienna; and the Department of Plastic Surgery, Southmead Hospital, North Bristol NHS Trust.

Background: Although the distal targets have been lost in proximal upper limb amputees, the neural signals for intuitive hand and arm function are still available and thus can be incorporated into more useful prosthetic function using targeted muscle reinnervation technique. In this article, the authors present their outcomes and range of indications in addition to experiences and pitfalls after 30 targeted muscle reinnervation cases at above-elbow and shoulder disarticulation level of amputation.

Methods: Thirty patients with above-elbow or shoulder disarticulation amputations were enrolled between 2012 and 2017. Read More

Mil Med 2020 03;185(3-4):444-450

Extremity Trauma and Amputation Center of Excellence, 3551 Roger Brooke Drive, JBSA Fort Sam Houston, TX 78234.

Introduction: Military Service Members (SMs) with upper limb (UL) amputation have unrestricted access to occupational therapy (OT) services. Identifying OT interventions used based on clinical rationale and patient needs can provide insight toward developing best practice guidelines. The purpose of this retrospective observational study was to identify preferred OT practice patterns for U. Read More