Page 482 - Read Online

Page 6 of 7 Luthringer et al. Plast Aesthet Res 2020;7:42 I http://dx.doi.org/10.20517/2347-9264.2020.35

Patients’ baseline functional status, occupation, type of injury sustained, and type of prosthetic used is
[7]
unique to each patient, rendering a definitive cost benefit analysis difficult to produce . Initial costs of
limb replantation exceed the cost of revision amputations [33,35] . However, advanced prostheses such as those
involving targeted muscle reinnervation and myoelectric prosthesis can be incredibly expensive [12,33] . While
pain and difficulty of prosthetic use are some of the most common reasons for prothesis disuse by patients,
[33]
financial burden is another commonly cited reason for prothesis abandonment . Intensive rehabilitation
[36]
is required for both replantation and prosthesis use in order to regain the most function .
CONCLUSION
Upper extremity amputations are devastating injuries. However, with appropriate management strategies
in place, major limb replantation is a potentially life changing option for those who have suffered these
injuries. While major limb replantation is not a viable option for every patient, the authors emphasize the
importance of appropriate patient selection and surgical management strategies, including aggressive soft
tissue and bone debridement in order to improve outcomes in these injuries.

DECLARATIONS
Acknowledgments
The authors would like to acknowledge Dr. Ramazi Datiashvili for his expert advice.

Authors’ contributions
Wrote the manuscript: Luthringer M, Dalena M
Approved the final version of the manuscript: Luthringer M, Dalena M, Ayyala HS
Conceived the study: Ayyala HS
Provided critical revisions that are important for intellectual content: Ayyala HS
Supervision and project administration: Ayyala HS
Contributed equally to this article: Luthringer M, Dalena M, Ayyala HS

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2020.

REFERENCES
1. Hanel DP, Chin SH. Wrist level and proximal-upper extremity replantation. Hand Clin 2007;23:13-21.
2. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States:
2005 to 2050. Arch Phys Med Rehabil 2008;89:422-9.