|Beitragstitel||Transhumeral amputation in brachial plexus lesion patients. A multicenter case series.|
Introduction: A flail limb can be the result of a traumatic complete brachial plexus lesion. An elective amputation has a place in the rehabilitation, however long-term follow-up is unknown. The aim of this study is to evaluate the outcome of this rare and life changing operation 10 years postoperatively.
Methods: 8 Patients with a mid-humeral amputation executed in 2 specialized medical centers were included. Psychological disorders were ruled out and all patients had a persisting whish for amputation. Postoperatively, the functional- and psychological outcome and the quality of life was evaluated with PROMs and standardized questionnaires (DASH, SIP-68, EQ-5D-5L and HADS).
Results: After 9.7 years follow-up 7 patients would undergo the operation again and were satisfied with the results. At latest follow-up the median DASH score was 37,3 (range 8,3-61,7), the median SIP-68 score was 6,5 (range 0-43) and the median HADS score was 3,0 (range 0-14) for anxiety and 3,0 (range 1-19) for depression. In the EQ-5D-5L patients had most difficulties in self-care, usual activities and pain/discomfort. The median overall health status was 69 (range 20-95).
Conclusion: A mid-humeral amputation has a place in the rehabilitation for traumatic complete brachial plexus lesion with satisfying long-term results. However, setting the right indication is essential.