Near Hand Amputation: A Report of Four Cases

Abstract

Background:The hand is an important part of the body that helps man express his thought and skills to the physical world. It is very essential to both function and cosmesis. Loss of this important body part can be devastating to the victim. We defined near total hand amputation as injury between the wrist and musculotendinous junction of extrinsic muscles of the hand transecting extensor and flexor compartment structures either passing through the wrist joint or transecting the two bones of the forearm leaving the hand attached to strip(s) of soft tissue.There are few reported cases of this type of injuries and most often completion amputation is done with loss of the hand. This study reports the outcome of near total hand amputation repair without revascularization in four patients seen and managed in Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) in 2020. This shows that with basic surgical equipment, hand salvage surgeries can be done with very good outcome. Methods: Consecutive Patients with near total hand amputation seen and managed in ATBUTH in 2020 were recruited for this case series report. Results: Four patients with such injury were seen and managed within four months in 2020. Three had their hands repaired with very good outcome while one had a completion amputation. Three out of the four had injury to their right hand, all four were right-handed males in their third decade of life and injuries commenced from ulnar borders. Majority had transection of virtually all structures except branches of major vessels. Conclusion: The study shows that a number of near hand amputation can be salvaged with basic equipment with significant functional and cosmetic outcome.