forearm amputation

1. The primary malignant tumor of the limb should be amputated at an early high position. In the early stage of the disease, the lesion is limited to the bone. If there is no distant metastasis, the tumor segment can be resected and the distal limb replanted. 2. Severe infection of the limbs (such as uncontrollable gas gangrene), or suppurative infections that are uncontrollable by drugs and general surgery, complicated by severe sepsis, threatening the life of the patient. Those who are not amputated to save lives should be amputated in time. 3. Serious and extensive injuries to the limbs, those who cannot be repaired or replanted, must perform amputation immediately. 4. Due to arterial thrombosis, thromboangiitis, arteriosclerosis, diabetes and other reasons caused by insufficient blood supply to the limbs, there are obvious necrosis, should be amputated. 5. Congenital multi-finger (toe), can be cut off. 6. Severe deformity of the limb affects the function, while orthopedic surgery can not improve the function. After the amputation, the prosthetic can improve the function, and the amputation can be considered. Treatment of diseases: thromboangiitis obliterans Indication 1. The primary malignant tumor of the limb should be amputated at an early high position. In the early stage of the disease, the lesion is limited to the bone. If there is no distant metastasis, the tumor segment can be resected and the distal limb replanted. 2. Severe infection of the limbs (such as uncontrollable gas gangrene), or suppurative infections that are uncontrollable by drugs and general surgery, complicated by severe sepsis, threatening the life of the patient. Those who are not amputated to save lives should be amputated in time. 3. Serious and extensive injuries to the limbs, those who cannot be repaired or replanted, must perform amputation immediately. 4. Due to arterial thrombosis, thromboangiitis, arteriosclerosis, diabetes and other reasons caused by insufficient blood supply to the limbs, there are obvious necrosis, should be amputated. 5. Congenital multi-finger (toe), can be cut off. 6. Severe deformity of the limb affects the function, while orthopedic surgery can not improve the function. After the amputation, the prosthetic can improve the function, and the amputation can be considered. Preoperative preparation 1. Amputation will bring severe mental and physical trauma to the patient. Therefore, the patient and his relatives should be explained in detail about the necessity of amputation and the problems in the assembly and use of the prosthesis. In the case of an open amputation, it is necessary to state that the amputation must be performed again. 2. Patients who are amputated after an open amputation are best to wait for the wound to heal after surgery; if they are not healed, they should be skin grafted first. 3. Except for those who have necrosis due to insufficient blood supply, all amputations should be placed on the proximal end of the truncated plane to inflate the tourniquet to reduce blood loss and keep the field clear. 4. In general, patients with high amputees should be prepared for blood transfusion before surgery to prevent shock. 5. Various special circumstances, such as diabetes, malignant tumors, etc., should be controlled with insulin or anti-tumor drugs before and after surgery. Surgical procedure 1. Position: In the supine position, the side of the torso is as close as possible to the edge of the operating table, and the limb is abducted and placed flat on another small operating table. The upper arm is placed with an inflatable tourniquet. 2. Design flap: The amputation above the wrist joint, the front and back flaps should be equal in length, each equal to 1/2 of the diameter of the truncated plane (about 1/3 circumference), and the intersection of the anterior and posterior flaps is in the plane of osteotomy The outer midpoint makes the incision scar just fall in the middle of the stump. The tangential line and the truncated plane of the flap are marked on the body surface. Cut the skin, subcutaneous tissue and deep fascia, separate under the fascia, and flap the flap to the truncated plane. 3. Cut off blood vessels and nerves: the separation ruler, the radial artery, the median nerve, and the ulnar nerve, and cut off after routine treatment. Note that in different truncated planes, the anatomical locations of blood vessels and nerves will vary. The cross-sectional view of the limb is seen in the blood vessels and nerve locations of different sections. 4. Amputation: 2cm under the truncated plane, with the amputation nine perpendicular to the bone, circularly cut the muscle, in the plane of muscle retraction, protect the proximal muscle, cut the periosteum, saw the broken ruler, the humerus, cut off the diseased limb, the plane edge. 5. Dispose of the stump: loosen the tourniquet and stop the bleeding completely. After the proximal end of the pressure check the ligature of the blood vessel is firmly secured, the section can be washed, the length of the muscle and the flap can be trimmed, the deep fascia and the flap can be sutured after the rubber skin is drained, and the stump is finally pressurized.