Elective amputation of the upper limb is an option in the treatment of traumatic injuries of the brachial plexus?

Mário Gilberto Siqueira; Roberto Sérgio Martins; Carlos Otto Heise; Luciano Foroni

doi:10.1590/0004-282X20170096

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(09): 667-670
DOI: 10.1590/0004-282X20170096

VIEWS AND REVIEWS

Elective amputation of the upper limb is an option in the treatment of traumatic injuries of the brachial plexus?

A amputação eletiva do membro superior é uma opção no tratamento das lesões traumáticas do plexo braquial?

Mário Gilberto Siqueira

¹Universidade de São Paulo, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia do Nervo Periférico, São Paulo SP, Brasil.

,

Roberto Sérgio Martins

¹Universidade de São Paulo, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia do Nervo Periférico, São Paulo SP, Brasil.

,

Carlos Otto Heise

¹Universidade de São Paulo, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia do Nervo Periférico, São Paulo SP, Brasil.

,

Luciano Foroni

¹Universidade de São Paulo, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia do Nervo Periférico, São Paulo SP, Brasil.

› Author Affiliations

Abstract

ABSTRACT

The treatment of complete post-traumatic brachial plexus palsy resulting in a flail shoulder and upper extremity remains a challenge to peripheral nerve surgeons. The option of upper limb amputation is controversial and scarcely discussed in the literature. We believe that elective amputation still has a role in the treatment of select cases. The pros and cons of the procedure should be intensely discussed with the patient by a multidisciplinary team. Better outcomes are usually achieved in active patients who strongly advocate for the procedure.

RESUMO

O tratamento das paralisias completas após lesões traumáticas do plexo braquial que resultam em um membro superior completamente paralisado permanecem como um desafio aos cirurgiões de nervos periféricos. A opção de amputar o membro superior é controversa e raramente discutida na literatura. Acreditamos que a amputação eletiva ainda tem utilidade no tratamento de casos selecionados. Os prós e contras do procedimento devem ser intensamente discutidos com o paciente por uma equipe multidisciplinar. Os melhores resultados são geralmente obtidos em pacientes atuantes que reivindicam vigorosamente o procedimento.

brachial plexus neuropathies - amputation - upper extremity - artificial limbs

neuropatias do plexo braquial - amputação - extremidade superior - dor por deaferentação - membros artificiais

Full Text

References

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