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Ann Vasc Surg 2018 Nov 28. Epub 2018 Nov 28.

Department of Vascular Surgery, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.

Angiosarcomas developing in nonfunctioning arteriovenous fistulas in renal transplant recipients are quite rare clinical entities with very poor prognosis. Herein we present a 60-year-old male who developed an angiosarcoma in a thrombosed radiocephalic fistula 6 years after renal transplantation. The patient presented with pain and swelling at the site of a previously asymptomatic fistula. Read More

Can J Surg 2018 12;61(6):S203-S207

From the Royal Canadian Medical Service, Ottawa, Ont. (Smith, DaCambra, McAlister); and the Division of General Surgery, Western University, London, Ont. (Smith, McAlister).

Background: We have previously reported a higher than expected rate of upper-extremity amputation (UEA) in victims of an antipersonnel improvised explosive device (AP-IED) compared with a similar cohort injured by antipersonnel mines (APM). The goal of this study was to describe the rate, severity and impact of UAE caused by an AP-IED.

Methods: We analyzed a prospective database of 100 consecutive dismounted AP-IED victims with pattern 1 injuries to compare the outcomes of the cohort with UEA to that without. Read More

J Burn Care Res 2019 Jan;40(1):107-111

Department of Surgery, University of Texas Medical Branch and Shriners Hospitals for Children-Galveston® Galveston, Texas.

Electrical injuries induce substantial morbidity and mortality. Amputations are often necessary to enable survival and based on tissue nonviability, development of life-threatening infection, or expected nonfunctional outcome. They analyzed occurrence and type of amputations in their institution for electrical and nonelectrical pediatric burns and the number of reconstructive operations. Read More

Sci Rep 2018 Oct 18;8(1):15459. Epub 2018 Oct 18.

Aix Marseille Univ, CNRS, ISM, Marseille, France.

There is an increasing need to extend the control possibilities of upper limb amputees over their prosthetics, especially given the development of devices with numerous active joints. One way of feeding pattern recognition myoelectric control is to rely on the myoelectric activities of the residual limb associated with phantom limb movements (PLM). This study aimed to describe the types, characteristics, potential influencing factors and trainability of upper limb PLM. Read More

J Vasc Surg 2019 Jan 29;69(1):120-128.e2. Epub 2018 Jul 29.

Division of Vascular and Endovascular Surgery, Department of Surgery, Long School of Medicine, University of Texas Health at San Antonio, San Antonio, Tex; South Texas Center for Vascular Care, South Texas Medical Center, San Antonio, Tex. Electronic address:

Background: Critical hand ischemia owing to below-the-elbow atherosclerotic occlusive disease is relatively uncommon. The aim of this study was to examine the outcomes in patients presenting with critical ischemia owing to below-the-elbow arterial atherosclerotic disease who underwent nonoperative and operative management.

Methods: A database of patients undergoing operative and nonoperative management for symptomatic below-the-elbow atherosclerotic disease between 2006 and 2016 was retrospectively queried. Read More

Rev Port Cir Cardiotorac Vasc 2017 Jul-Dec;24(3-4):179

Hospital de Santa Marta, Portugal.

Introduction: With increasing use of percutaneous vascular procedures, access complications that present to a vascular surgeon increase. The most limb-threatening condition is acute limb ischaemia. Acute limb ischaemia is the most common vascular surgical emergency. Read More

Plast Reconstr Surg 2018 06;141(6):1447-1458

Toronto, Ontario, Canada From the Division of Plastic and Reconstructive Surgery, Department of Surgery, and the Institute of Biomaterials and Biomedical Engineering, University of Toronto; the Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children; and Orthotics and Prosthetics, Holland Bloorview Kids Rehabilitation Hospital.

Prosthetic options for patients with proximal upper limb absence are limited. Current above-elbow prostheses may restore basic motor functions for crucial activities, but they are cumbersome to operate, lack sensory feedback, and are often abandoned. Targeted muscle reinnervation is a novel surgical procedure that enhances the ability of patients with above-elbow amputations to intuitively control a myoelectric prosthesis. Read More

Brain 2017 Dec;140(12):3166-3178

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

Denervation due to amputation is known to induce cortical reorganization in the sensorimotor cortex. Although there is evidence that reorganization does not lead to a complete loss of the representation of the phantom limb, it is unclear to what extent detailed, finger-specific activation patterns are preserved in motor cortex, an issue that is also relevant for development of brain-computer interface solutions for paralysed people. We applied machine learning to obtain a quantitative measure for the functional organization within the motor and adjacent cortices in amputees, using high resolution functional MRI and attempted hand gestures. Read More

JAMA 2017 Oct;318(16):1581-1591

Joint Trauma System, Defense Center of Excellence for Trauma, Fort Sam Houston, San Antonio, Texas.

Importance: Prehospital blood product transfusion in trauma care remains controversial due to poor-quality evidence and cost. Sequential expansion of blood transfusion capability after 2012 to deployed military medical evacuation (MEDEVAC) units enabled a concurrent cohort study to focus on the timing as well as the location of the initial transfusion.

Objective: To examine the association of prehospital transfusion and time to initial transfusion with injury survival. Read More

IEEE Int Conf Rehabil Robot 2017 07;2017:1457-1464

Prosthetic arms should restore and extend the capabilities of someone with an amputation. They should move naturally and be able to perform elegant, coordinated movements that approximate those of a biological arm. Despite these objectives, the control of modern-day prostheses is often nonintuitive and taxing. Read More

J Orthop Case Rep 2017 Jan-Feb;7(1):3-8

Department of Orthopaedics, Preethi Hospitals Pvt. Ltd., Madurai, Tamil Nadu, India.

Introduction: Mangled upper limb injuries are at surge because of industrialization, modernization, and severe motor vehicle accidents. The utility of various scoring systems are meant for decision making in mangled lower limb injuries, and the same have been extrapolated for mangled upper limb injuries to make a decision of salvage or amputation for the lack of separate scoring system.

Materials And Methods: We applied mangled extremity severity score (MESS) and mangled extremity syndrome index (MESI) scoring systems to 10 cases of mangled upper limb injuries during the period of November 2010 to September 2012 presented at our tertiary trauma care center. Read More

J Am Acad Orthop Surg 2017 May;25(5):339-347

From the Department of Orthopaedic Surgery, University of Texas Health Science Center, Houston, TX (Dr. Choo and Dr. Burgess), and the Department of Orthopaedics and Rehabilitation, University of Vermont Medical Center, Burlington, VT (Dr. Schottel).

Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Read More

J Occup Rehabil 2018 Mar;28(1):158-169

Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, PO BOX 30001, 9700 RB, Groningen, The Netherlands.

Purpose To develop and pilot test a functional capacity evaluation (FCE) for individuals with upper limb absence (ULA) due to reduction deficiency or amputation, and to examine the relationship between FCE results and presence of musculoskeletal complaints (MSC). Method Five tests (overhead lifting, overhead working, repetitive reaching, fingertip dexterity, and handgrip strength) were selected and adapted if necessary. The newly developed FCE, called FCE-One-Handed (FCE-OH), was pilot tested in 20 adults individuals with ULA, and 20 matched controls. Read More

J Neuroeng Rehabil 2017 Jan 7;14(1). Epub 2017 Jan 7.

Chinese Academy of Sciences (CAS) Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Shenzhen, 518055, China.

Background: Most of the modern motorized prostheses are controlled with the surface electromyography (sEMG) recorded on the residual muscles of amputated limbs. However, the residual muscles are usually limited, especially after above-elbow amputations, which would not provide enough sEMG for the control of prostheses with multiple degrees of freedom. Signal fusion is a possible approach to solve the problem of insufficient control commands, where some non-EMG signals are combined with sEMG signals to provide sufficient information for motion intension decoding. Read More

Mil Med 2016 08;181(8):773-6

Department of Orthopaedics and Rehabilitation, San Antonio Military Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234.

Introduction: Upper extremity amputation is associated with significant disability. Elbow arthrodesis (EA) is a rarely indicated salvage procedure with a narrow set of indications. The purpose of this case series is to describe the clinical course of those patients undergoing an EA following severe combat-related, upper extremity trauma. Read More

J Plast Reconstr Aesthet Surg 2016 Mar 26;69(3):311-7. Epub 2015 Oct 26.

Mayo Clinic, Department of Orthopedic Surgery, Division of Hand Surgery, 200 1st Street South West, Rochester, MN 55905, USA. Electronic address:

Background And Aim: Despite undergoing complex brachial plexus, surgical reconstructions, and rehabilitation, some patients request an elective amputation. This study evaluates the role of elective amputation after brachial plexus injury.

Methods: A retrospective chart review was performed for all the 2140 patients with brachial plexus injuries treated with elective amputation between 1999 and 2012 at a single institution. Read More

Anesth Pain Med 2015 Dec 30;5(6):e24025. Epub 2015 Nov 30.

Tameside Hospital, Ashton-Under-Lyne, UK.

Introduction: The brachial plexus block is a commonly performed procedure in the anesthetic practice today. It is performed for analgesia as well as anesthesia for upper limb procedures. It has been used for amputation and replantation surgeries of the upper limb. Read More

Lymphat Res Biol 2016 Mar 19;14(1):35-9. Epub 2015 Nov 19.

1 Division of Plastic Surgery, Department of Trauma Surgery, Plastic and Reconstructive Surgery, University Medical Centre , Göttingen, Germany .

Background: Stewart-Treves syndrome is a rare complication of breast cancer treatment, representing a lymphangiosarcoma commonly associated with lymphedema and severely impacting patient's outcome. The tumor typically develops in the atrophic, pachydermatous, hyperkeratotic skin of limbs affected by long-standing lymphedema. Clinical data associated with Stewart-Treves syndrome and lymphedema management have rarely been published. Read More

J Shoulder Elbow Surg 2015 Nov;24(11):1757-63

Department of Orthopedic Surgery and Traumatology, Niguarda Hospital, Milan, Italy.

Background: Surgical arthrodesis of the elbow joint is frequently unsuccessful and rarely performed. It is the purpose of this article to evaluate tactics and different constructs to achieve elbow arthrodesis (EA) using the Ilizarov apparatus in patients with post-traumatic nonreconstructable elbow sequelae.

Methods: A consecutive series of 4 patients were treated between 2009 and 2013 (3 men and 1 woman; mean age, 46. Read More

J Pain Res 2015 24;8:641-5. Epub 2015 Sep 24.

Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA ; Department of Anesthesiology and Pain Medicine, The Ohio State University, Columbus, OH, USA.

Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. Read More

PLoS One 2015 4;10(9):e0137729. Epub 2015 Sep 4.

Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Background: Traumatic arm amputations can be treated with replantation or surgical formalization of the stump with or without subsequent prosthetic fitting. In the literature, many authors suggest the superiority of replantation. This systematic review compared available literature to analyze whether replantation is functionally and psychologically more profitable than formalization and prosthetic fitting in patients with traumatic arm amputation. Read More

Int J Surg Pathol 2015 Dec 27;23(8):649-51. Epub 2015 Jul 27.

Royal Marsden Hospital, London, UK

Intraneural extension of soft tissue sarcomas is uncommon; it is most frequently seen in malignant peripheral nerve sheath tumor, but its occurrence is exceptional in synovial sarcoma. We describe a case arising extraneurally within the deep soft tissues of the forearm, which recurred and resulted in above-elbow amputation, revealing an unexpected finding of diffuse intraneural extension of tumor within a macroscopically normal major nerve. Despite macroscopic and microscopically clear soft tissue margins, the neoplasm had "traveled" a significant distance intraneurally to involve the neural resection margin. Read More

J Perioper Pract 2014 Dec;24(12):286-7

The loss of Horatio Nelson's right arm is undoubtedly the best known amputation in this country's history and the story is well worth the telling. In 1797, the 38 year old Nelson, then a Rear Admiral, devised a plan for a surprise night attack to seize treasure ships, which he believed were sheltering at Santa Cruz on Tenerife, (one of the Canary Islands). On the night of July 24th, Nelson led an armada of rowing boats from his fleet, anchored below the horizon. Read More

Am J Phys Med Rehabil 2015 Dec;94(12):1052-7

From the Departments of Physical Medicine and Rehabilitation (MRB, MJT, SWD, KLA, CCP) and Pediatric and Adolescent Medicine (SWD, DBS), Mayo Clinic and Foundation, Rochester, Minnesota.

Objective: The objective of this study was to determine if wrestling is a safe, positive athletic option for limb-deficient individuals.

Design: This descriptive study consisted of an opportunity sample of limb-deficient wrestlers, aged 5 yrs and older with at least 1 yr of experience. Participants completed a questionnaire regarding health, satisfaction, and achievements. Read More

Australas J Dermatol 2016 May 5;57(2):e53-6. Epub 2015 Mar 5.

Department of Radiation Oncology and Crown Princess Mary Cancer Care Centre, Westmead Hospital, Sydney, New South Wales, Australia.

We report an unusual case of Merkel cell carcinoma in a 70-year-old woman with the rapid development of left upper limb in-transit and hepatic metastases. The patient had a preceding history of left-sided breast cancer. Palliative chemotherapy with carboplatin and etoposide produced a minimal response. Read More

J Rural Med 2014 10;9(1):37-9. Epub 2014 Apr 10.

Department of Cardiovascular Surgery, Yuri-Kumiai General Hospital, Japan.

Objective: The aim of the present study was to consider the importance of medical information obtained via the Internet for difficult cases in hospitals, especially in those located in rural areas. We report here a case of congenital arteriovenous fistula (AVF) in the upper extremities.

Patient: A 30-year-old lady was transported to our hospital by ambulance due to massive bleeding in her left hand. Read More

Int J Surg Case Rep 2015 12;6C:280-4. Epub 2014 Dec 12.

University Orthopaedics, Buffalo General Hospital, 100 High Street, Buffalo, NY 14203, USA. Electronic address:

Introduction: The prognosis of patients with metastatic breast cancer is very poor. Because of this, treatment of skeletal metastasis is often palliative with limited goals rather than cure. However, there are those patients, such as presented here, who survive for an extended time. Read More

J Med Biogr 2016 Aug 15;24(3):363-71. Epub 2014 May 15.

Surgeon Commander, Royal Naval Medical Service, and Consultant Orthopaedic Surgeon, MDHU, Derriford Hospital, Plymouth, UK.

Horatio Nelson is an icon of British naval history. His above-elbow amputation by Thomas Eshelby remains one of the most famous surgical procedures ever performed. Yet the surgeon himself remains relatively obscure and uncelebrated. Read More

Phys Med Rehabil Clin N Am 2014 Feb;25(1):199-212

Amputee Services of America, 1601 East 19th Avenue, Suite 3200, Denver, CO 80218, USA. Electronic address:

This article provides a generalized overview of amputation classifications and the idealized outcomes for upper and lower amputations at their respective levels. The following levels are discussed: above knee/transfemoral, below knee/transtibial, above elbow/transhumeral, below elbow/transradial, and bilateral for upper and lower extremities. This classification defines a framework for clinicians to share with patients so that they understand the potential for their expected functional outcomes regarding mobility and activities of daily living, both with and without a prosthesis. Read More

Tech Hand Up Extrem Surg 2013 Dec;17(4):221-7

*Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine †Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.

Vascularized composite allotransplantation, also known as "Reconstructive Transplantation" is becoming more commonplace worldwide. Hand and upper extremity transplantation make up the majority of clinical vascularized composite allotransplantation cases performed so far. As success with reconstructive transplantation becomes more common, more challenging examples of limb loss are being addressed, including above-elbow, or "supracondylar" upper extremity transplants. Read More

Hepat Mon 2013 11;13(8):e10858. Epub 2013 Aug 11.

Department of Liver Transplantation, King Faisal Specialist Hospital and RC, Riyadh, Saudi Arabia.

Introduction: Cutaneous Mucormycosis is a rare opportunistic infection caused by Zygomycetes class of fungi that is often fatal, requiring aggressive local control as well as systemic therapy. Few cases of mucormycosis were described in patients with liver cirrhosis, mostly rhino-orbital. To our knowledge, only two cases of upper extremity involvement was reported in cirrhosis while a few cases were reported in the post-transplant setting. Read More

Conf Proc IEEE Eng Med Biol Soc 2012 ;2012:4332-5

Electrical Engineering Department, Bioelectronics Section, CINVESTAV-IPN, Mexico, D.F., Mexico.

Individuals with a transhumeral amputation have a large functional deficit and require basic functions out of their prosthesis. Myoelectric prostheses have used amplitude control techniques for decades to restore one or two degrees of freedom to these patients. Pattern recognition control has also been investigated for transhumeral amputees, but in recent years, has been more focused on transradial amputees or high-level patients who have received targeted muscle reinnervation. Read More

Niger J Med 2012 Apr-Jun;21(2):249-51

Department of Orthopaedics and Traumatology, National Orthopaedic Hospital, Enugu, Nigeria.

Background: Human bite is a common injury sustained during a fight, love passion, self mutilation, cannibalism or vampirism. Although widely reported as being more dangerous than animal bites, such complications as limb amputation from gangrene and eventually death is either uncommon or scarcely reported in our environment.

Objective: To highlight the dangers of human bite as a potential cause of severe morbidity and mortality especially when poorly managed. Read More

J Emerg Trauma Shock 2012 Oct;5(4):363-6

Department of Surgery, Arrowhead Regional Medical Center, Colton, CA, USA.

Scapulothoracic dissociation (STD) is a devastating consequence of high-energy trauma sustained by the shoulder girdle that can easily result in rapid mortality. Since described by Oreck et al. in 1984, STD has been reported in a handful of journals and individual case series, though is still considered a rare occurrence in the context of shoulder injuries. Read More

Acupunct Med 2013 Mar 6;31(1):101-4. Epub 2012 Dec 6.

Brynhyfryd Surgery, Brynhyfryd Square, Swansea SA5 9EB, UK.

A 45-year-old man presented with phantom limb pain and phantom limb sensation 12 weeks after an above-elbow amputation of his right arm. He underwent seven sessions of acupuncture at weekly intervals carried out by his general practitioner on his intact left arm, with complete relief of the phantom limb pain and considerable improvement of the phantom limb sensation of his right arm. This case demonstrates the possible benefits from the use of short acupuncture sessions for a potentially chronic condition undertaken within the constraints of a busy general medical practice. Read More

Case Rep Pathol 2012 3;2012:353215. Epub 2012 Nov 3.

Department of Pathology, J.S.S. Medical College, J.S.S. University, Karnataka, Mysore, 570015, India.

Neurofibromas are uncommon benign tumours and are still rarer in intramuscular locations. They are not detected until they cause a significant damage to the neighbouring tissues. We present a case of a giant intramuscular myxoid neurofibroma of the left forearm which eroded the radius and ulna, restricting the movements at the elbow and wrist joints and causing wrist drop resulting in an above elbow amputation. Read More

Chir Main 2012 Oct 7;31(5):221-6. Epub 2012 Sep 7.

Service de chirurgie plastique et reconstructrice de l'appareil locomoteur, hôpital d'enfant, CHU de Nancy, rue du Morvan, 54000 Brabois-Vandœuvre-lès-Nancy, France.

Digital amputations in children are usually caused by crush or avulsion injuries (door hinge, bicycle chain, etc.). The preponderance of this mechanism of injury means a survival rate generally lower than in adults. Read More

Acta Anaesthesiol Belg 2012 ;63(1):51-3

Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

The role of regional anesthetic techniques such as cervical epidural and inter-scalene brachial plexus blockade (ISB) in rehabilitated stroke patients remains uncertain. We present a case of rehabilitated stroke patient with reactive airway disease, which was managed using cervical epidural anesthesia for an above the elbow amputation. We further discuss the implications of the performance of cervical epidural anesthesia in post stroke patients. Read More

J Hand Surg Am 2012 Jun 5;37(6):1235-41. Epub 2012 Apr 5.

Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore, Singapore.

Purpose: With the continued advancement of limb salvage surgery, major upper-limb amputations are being performed less frequently and are generally reserved for patients with large, multifocal, or recurrent tumors for whom limb salvage is no longer an option. We conducted a retrospective review of the current indications and patient outcomes after major upper-limb amputations for malignant tumors.

Methods: Using the institution surgical database, we identified 43 patients who underwent major upper-limb amputation for primary and metastatic malignant tumors from 1996 to 2008. Read More

Ann Vasc Surg 2012 Jul 8;26(5):655-64. Epub 2012 Feb 8.

The Vascular and Vein Center, Grant Medical Center, Columbus, OH, USA.

Background: Upper-extremity arterial injuries are relatively uncommon, but they may significantly impact patient outcome. Management of these injuries was reviewed to determine incidence, assess the current management strategy, and evaluate hospital outcome.

Methods: Upper-extremity trauma patients presenting with arterial injury between January 2005 and July 2010 were included in this retrospective review. Read More

J Rehabil Res Dev 2011 ;48(6):739-54

Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA.

Upper-limb amputation can cause a great deal of functional impairment for patients, particularly for those with amputation at or above the elbow. Our long-term objective is to improve functional outcomes for patients with amputation by integrating a fully implanted electromyographic (EMG) recording system with a wireless telemetry system that communicates with the patient's prosthesis. We believe that this should generate a scheme that will allow patients to robustly control multiple degrees of freedom simultaneously. Read More

Am J Transplant 2011 May;11(5):1085-90

Reconstructive surgery, Clínica Cavadas, Valencia, Spain.

Unilateral and bilateral hand transplantations have been performed worldwide with good mid-term functional results. An above-elbow bilateral transplantation was performed in a 29-year-old male patient from a fully HLA-mismatched donor. Alemtuzumab induction and steroid-free maintenance immunosuppression with tacrolimus and mycophenolate was used. Read More

J Hand Surg Am 2011 May 12;36(5):808-10. Epub 2011 Apr 12.

Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA.

Purpose: To describe the intraosseous arterial anatomy of the proximal ulna.

Methods: We used 9 fresh-frozen, above-elbow amputations to map the intraosseous arterial supply using the Spalteholtz technique. We treated 3 additional above-elbow amputations similarly, and then dissected them to map the extraosseous arterial supply. Read More

Hong Kong Med J 2011 Apr;17(2):96-104

Department of Orthopaedics, Caritas Medical Centre, Shamshuipo, Kowloon, Hong Kong.

Objective: To identify predictive factors for mortality of patients with upper limb necrotising fasciitis.

Design: Retrospective study.

Setting: Six hospitals in Hong Kong. Read More

Hum Brain Mapp 2011 Apr;32(4):509-19

Center for Interdisciplinary Research in Rehabilitation and Social Integration, Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, QC, Canada.

It is generally considered that hand amputation changes primary motor cortex (M1) stump muscle representations. Transcranial magnetic stimulation (TMS) studies show that the corticospinal excitability of a stump muscle and its homologous muscle on the intact side is not equivalent, and that the resting level of excitability is higher in the stump muscle. Since changes in M1 stump muscle map characteristics (e. Read More

Conf Proc IEEE Eng Med Biol Soc 2010 ;2010:2259-62

Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico.

This article describes a patient training evolution to achieve myoelectric control in the remnant limb. The methodology is divided in two main stages: (i) the training procedure, where the patient is submitted to a protocol for educating the muscles of the remnant limb, and (ii) myoelectric signal acquisition and analysis, in order to measure the patient evolution to reach different contraction levels along the training sessions. After three training stages, the results suggest that the patient gradually achieved strength control over the muscles of the remnant limb. Read More

Transplant Proc 2010 Sep;42(7):2794-6

Department of Surgery, University of Florida College of Medicine, Gainesville, 32610-0286, USA.

Mucormycosis is an uncommon but frequently fatal infectious complication after solid organ transplantation. We describe successful treatment of invasive mucormycosis in a liver transplant recipient by wound debridement, a right above-elbow arm amputation, and antifungal medications. Early recognition, prompt operative intervention, and initiation of an appropriate antifungal treatment are very important in the management of mucormycosis, a potentially life-threatening infection. Read More

J Orthop Surg Res 2010 Jun 22;5:39. Epub 2010 Jun 22.

Department of orthopaedic surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Keshavarz Blvd, Tehran 1419733141, Iran.

Spinal cord injury is a well-known predisposing factor for development of heterotopic ossification around the joints especially hip and elbow. Heterotopic ossification about the knee is usually located medially, laterally or anteriorly; besides, the knee is generally fixed in flexion. There are only a few reports of heterotopic bone formation at the posterior aspect of the knee (popliteal space) and fixation of both knees in extension; so, there is little experience in operative management of such a problem. Read More

Singapore Med J 2009 Nov;50(11):e388-90

Department of Orthopaedics, Indraprastha Apollo Hospital, Delhi 110005, India.

A 52-year-old Indian woman presented with a progressively increasing swelling and pain in the right elbow for the past eight months, which was not associated with trauma or constitutional symptoms. The patient was diagnosed to have Campanacci grade III giant cell tumour of the proximal radius, and was treated with above elbow amputation. The patient has not shown any recurrence after five years of follow-up. Read More

J Med Case Rep 2009 Jun 5;3:6627. Epub 2009 Jun 5.

Introduction: A patient with a neglected, compound acutely ruptured false aneurysm of the brachial artery which developed after a periprosthetic fracture of the right humerus, is reported.

Case Presentation: An 84-year-old Greek woman underwent right shoulder hemiarthroplasty 2 years before a periprosthetic fracture which was treated conservatively in another hospital. After removing the U-slab herself, she noticed the development of an ulcer on the mid-humerus, with continuous oozing but no fever. Read More