Technical implications in proximal forearm transplantation

Nicholas T. Haddock, Benjamin Chang, David J. Bozentka, David R. Steinberg, Lawrence Scott Levin

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

The field of vascularized composite allotransplantation has developed for more than a decade. Investigators are defining patient selection criteria, transplant indications, immunologic regimens, and tolerance. The majority of the current reported hand transplantations have been for treatment of distal forearm or hand amputations. In more proximal amputees, the functional outcome of the transplanted arm has some unique variables that require a different surgical approach. We present a single case of bilateral proximal forearm transplantation in effort to describe the unique technical considerations in this complex procedure. The surgical procedure is described in detail. At 19 months, our patient had 4/5 strength of finger and thumb flexors and protective extensor as well as 4/5 wrist flexors and extensors. Our patient had recovery of sensation. Our patient now lives independently and does her lower extremity prosthesis independently using her hands. These results are expected to continue to improve with more time. In hand transplantation, functional results have been very promising. The described approach of forearm transplantation allows the transfer of the entire functional unit, which should optimize the ultimate outcome for these more proximal injuries.

Original languageEnglish (US)
Pages (from-to)228-231
Number of pages4
JournalTechniques in Hand and Upper Extremity Surgery
Volume17
Issue number4
DOIs
StatePublished - Dec 1 2013

Keywords

  • Composite allotransplant
  • Forearm transplant
  • Hand transplant
  • Transplant

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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