ISSN 2458-7834
 

Original Article 


A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation

Conrad Stoy, Stephanie A Kwan, Justin M Kistler, Jacob E Tulipan.

Abstract
Objectives
Amputation is a major source of morbidity and mortality. Non-traumatic amputations of the upper extremity are less common, and less well-characterized, than the lower extremity. We hypothesize that upper extremity amputations are often associated with multiple returns to the operating room.

Methods
Twenty-five patients were identified that underwent primary or revision ray or phalangeal amputations for vascular/infectious indications. Chart review was utilized to gather information on additional amputations and demographic information. These groups were compared via chi-squared analysis assuming equal distributions of operations would be present between groups.

Results
Of the patients with infectious and/or vascular amputations, 56% had a subsequent amputation. Additionally, 23 irrigation and debridement’s (I&D) were performed before resorting to amputation with 6 patients requiring multiple I&Ds. Post-amputation, 3 patients required I&D, 7 revision amputations at higher levels, 8 amputations of additional ipsilateral digits, and 4 amputations of contralateral digits were performed. After initial amputation, there is a 76% chance of undergoing an additional operation and/or amputation of the upper extremity. A subgroup of these patients with diabetes showed statistically significant increases in ipsilateral amputations following initial amputation.

Conclusions
Our study shows that patients undergoing digit amputation for nontraumatic indications may require additional upper extremity operations following initial amputation. Subsequent revision amputation at a higher level is common and suggests that more aggressive early amputation may be warranted in these patients. Specifically, diabetic patients are at significantly increased risk of requiring additional digit amputations and may benefit from more aggressive initial surgery at time of presentation.

Key words: Upper extremity, amputation, vascular, non-traumatic, digital amputation


 
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How to Cite this Article
Pubmed Style

Stoy C, Kwan SA, Kistler JM, Tulipan JE. A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation. Hand Microsurg. 2022; 11(2): 82-88. doi:10.5455/handmicrosurg.23893


Web Style

Stoy C, Kwan SA, Kistler JM, Tulipan JE. A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation. https://handmicrosurgeryjournal.com/?mno=23893 [Access: September 27, 2022]. doi:10.5455/handmicrosurg.23893


AMA (American Medical Association) Style

Stoy C, Kwan SA, Kistler JM, Tulipan JE. A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation. Hand Microsurg. 2022; 11(2): 82-88. doi:10.5455/handmicrosurg.23893



Vancouver/ICMJE Style

Stoy C, Kwan SA, Kistler JM, Tulipan JE. A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation. Hand Microsurg. (2022), [cited September 27, 2022]; 11(2): 82-88. doi:10.5455/handmicrosurg.23893



Harvard Style

Stoy, C., Kwan, . S. A., Kistler, . J. M. & Tulipan, . J. E. (2022) A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation. Hand Microsurg, 11 (2), 82-88. doi:10.5455/handmicrosurg.23893



Turabian Style

Stoy, Conrad, Stephanie A Kwan, Justin M Kistler, and Jacob E Tulipan. 2022. A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation. Hand and Microsurgery, 11 (2), 82-88. doi:10.5455/handmicrosurg.23893



Chicago Style

Stoy, Conrad, Stephanie A Kwan, Justin M Kistler, and Jacob E Tulipan. "A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation." Hand and Microsurgery 11 (2022), 82-88. doi:10.5455/handmicrosurg.23893



MLA (The Modern Language Association) Style

Stoy, Conrad, Stephanie A Kwan, Justin M Kistler, and Jacob E Tulipan. "A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation." Hand and Microsurgery 11.2 (2022), 82-88. Print. doi:10.5455/handmicrosurg.23893



APA (American Psychological Association) Style

Stoy, C., Kwan, . S. A., Kistler, . J. M. & Tulipan, . J. E. (2022) A Look at the Course and Management of Non-Traumatic Upper Extremity Amputation. Hand and Microsurgery, 11 (2), 82-88. doi:10.5455/handmicrosurg.23893





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