SUCCESSFUL REPLANTATION OF SEVERED ARM BY SHORTENING OF BONE
Although twelve years have passed since the first successful replantation of a traumatically amputated extremity was achieved by Malt in May 1962, the criterions for the indication of replantation and selection of the cases have not yet been clearly founded. Generally, cleanly severed limbs by sharp instruments with minimal contamination are more favorable for replantation than those with crushing and avulsion, especially if accompanied by gross contamination. On June 30, 1973, the authors had a opportunity to treat a 24-year-old man with his severed left arm which had been avulsed by a running train. The local conditions of the limb were so severe that we, initially, considered the case should be excluded from the indication. However, by performing a bold shortening of the humerus, we succeeded its replantation. The length of the shortened humerus was about 9 cm. This case illustrates a significance of bone shortening in replantation procedures. With a special emphasis to shortening of the bone, our policy for the management and replanation of severed limbs is summarized.