Management
Traumatic Amputation of the Extremity - Emergency Management
Editors: Margaret J. Lin-Martore MD; Luz Silverio MD; Rachel Chin MD
Background Information
Description
- Traumatic removal of a body part, usually an extremity()
- Amputations are either partial (appendage still attached) or complete (appendage completely separated form body)
Anatomy
- Amputation may damage numerous structures: skin, muscle, tendon, vasculature, nerves, bone
Etiology
- Avulsion: ripped and jagged edges()
- More associated morbidity
- Least successful rates of replantation
- Most frequent type of amputation
- Guillotine: clean edges()
- Higher rate of successful replantation
- Least frequent type of amputation
- Crush: irregular edges()
- Damaged tissue is usually crushed making it harder to replant
Epidemiology
- 5:1 predominance of males to females(,,)
- More common in children and elderly(,,)
- Upper extremity amputations more common than lower extremity amputations
- Caught between 2 objects, doors, power tools, gunshot are frequent causes
- Lower extremity amputations
- Power tools and motor vehicle collisions are the most common causes
- PEDIATRICS: accounts for 54% of the cases of traumatic amputations
- Usually fingers and toes
- Typically in young (aged 0-5 years) and older (aged 15-17 years) children()
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