RESUMEN
Reimplantation after subtotal section of the right lower limb under the Scarpa triangle was been attempted and was successful. Section and contusion of the femoral artery and vein required 2 end-to-end saphenous bypass grafts. The use of the lower limb is correct, after to a follow up of 4 years. The risks, inherent to all proximal section, with important muscular masses, in a small child, are described. Functional prognosis depends on three aspects: bone, vessels, and nerves. A tibial pseudarthrosis had to be operated secondarily with significant lengthening. A partial stenosis of the graft was demonstrated arteriographically. Pes equinus, a result of paralysis, has been fitted with an orthesis. This observation is almost an experimental one: what can be the future of a reimplanted lower limb in the child.
Asunto(s)
Amputación Traumática , Traumatismos de la Pierna/cirugía , Reimplantación , Preescolar , Arteria Femoral/lesiones , Arteria Femoral/cirugía , Fracturas del Fémur/cirugía , Vena Femoral/lesiones , Vena Femoral/cirugía , Estudios de Seguimiento , Humanos , Masculino , Complicaciones Posoperatorias , Pronóstico , Seudoartrosis/cirugía , Fracturas de la Tibia/cirugíaRESUMEN
Two replantations of nearly completely amputated limbs are presented. In both cases there were young children. These two success explain the necessity of limb preservation if the nerve integrity is respected. In the young child, the vital risk is lower because of the vessels, the local immunologic defense. The bone union is normal. The vascular suture with venous grafts is made with simple interrupted sutures rather than with continuous over and over sutures. The fasciotomy avoid a compartment syndrome. The bone graft growth is unforeseeable. These two case reports are nearly experimental because of the young age of the patients.