FOREQUARTER AMPUTATION PDF
Forequarter amputation (FQA) is a surgical treatment of tumors in the upper extremity and shoulder girdle that infiltrate the neurovascular. Forequarter or inter scapulothoracic amputation is an uncommonly performed operation for malignant tumours involving the proximal end of humerus and the. Forequarter amputation combined with chest wall resection is a rarely performed procedure. Six patients were treated for advanced malignancies with this.
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Abstract Forequarter interscapulothoracic amputation is a major ablative surgical procedure that was originally described to manage traumatic injuries of the upper extremity. Postoperatively she developed; excessive upward lift of the breast which was corrected with plastic repair.
This procedure is usually well tolerated in firequarter selected patients who are suffering intractable pain from a dysfunctional limb. Removal of acromial and cora-coid prominences is unnecessary and will further disrupt form as well as reduce leverage for body-powered prostheses.
The superior and medial borders of the scapula are then freed by division of the levator scapulae, rhomboids, and serratus anterior.
The clavicle was carefully elevated to expose the subclavian artery, vein and brachial plexus. Intraoperative view of the divided clavicle, ligated subclavian artery and vein, and ligated brachial plexus.
The surgery of arm and forearm amputations.
Initially she refused surgery. In cases of trauma, the lessons of military surgery must be well remembered and amlutation wound closure performed rarely, if at all. Myodesis ensures consistent electromyographic localization that may improve functional control and particularly proportional grasp for wearers of electric prostheses. Despite disfiguring results, forequarter amputation is an effective procedure to cure and palliate tumours qmputation the upper extremities 3.
Unfortunately, in our patient the skin flap and underlying muscle did not survive.
Because there was an initial congestion of the flap, a second end-to-end vein anastomosis needed to be made from the cephalic vein from the flap to the internal thoracic vein at the level of the third intercostal space. Ampuyation amputation stump itself is anputation no inherent functional value at these levels because even the ability to grasp or stabilize large objects between the residual limb and thorax will be eliminated. Palliative major amputation and quality of life in cancer patients.
J Reconstr Microsurg ; 3: Amputations of upper extremity, in Crenshaw AH ed: Her bone and visceral scan were normal. Support Center Support Center.
New York, Churchill Livingstone,p. Cases 1 and 3 bad the tumour six months and one year before they were admitted and biopsies taken. The clavicle is exposed subperiosteally and divided.
Received Jul 28; Accepted Oct 6. Then come onto chest wall immed anterior and divide Pec maj origin from remaining clav.
National Center for Biotechnology InformationU. The patient has foreequarter unresectable invasive tumour involving the shoulder joint or neurovascular bundle. GG is an 85 year old retired electrician with a complex past medical and surgical history which includes renal cell carcinoma, mesenteric carcinoid tumour, B-cell lymphoma, chronic lymphocytic leukemia and multiple basal cell carcinomas. Case 1 A female of 30 reported with a slowly increasing painful mass in the right upper arm for the last three months.
Although forequarter amputations are performed for curative management [ 1517 ], this type of procedure has typically been described in the context of palliative surgery with a post-operative survival of less than 2 years [ 151819 ]. It is usually performed as a last resort to remove a cancer, but decreasingly so as limb-sparing operations improve.
Forequarter Amputation for Tumours of the Upper Extremity
Because this procedure is so deforming, most surgeons and patients do not select this treatment option. Amputation has also been advocated as a palliative procedure for symptomatic, locally advanced disease that has already failed to respond to radiation therapy, chemotherapy and limited surgery 7. To obtain wound closure further clavicle and near-complete scapular body excision were necessary. J Shoulder Elbow Surg. Forequarter amputation for high-grade malignant tumours of the shoulder girdle.
The histopathology diagnosis was fibrosarcoma. Pre-operative embolization for the purpose of controlling intra-operative and post-operative blood loss is a described technique [ 9 ] and its use in conjunction with sarcoma resection has been reported [ 10 ] however its use in forequarter amputations has not been described.
The Article Processing Charge was paid for by the authors. To find out more about ABCD,the work we do and how forequadter funding is spent go to www. Although amputation through the amptation neck of the humerus is functionally equivalent to shoulder disarticulation, maintenance of shoulder width and axillary contour by the former procedure is a distinct cosmetic advantage.
Forequarter amputation – Wikipedia
The clavicle was exposed and divided at the proximal third; care was taken not to tear the underlying vein. Shoulder silhouette and axilla reconstruction with free composite elbow tissue transfer following interscapulothoracic amputation. Next, the chest wall attachments of the pectoralis major and minor were divided.