Severe upper limb injuries with or without neurovascular compromise in children and adolescents—Analysis of 32 cases

Abstract

The healing and regeneration capacity of the injured tissues in childhood, adolescence, and adult life differs significantly. As a result, the prognosis of compound injuries of the upper limb in different age groups varies; therefore, the decision making and management of these cases should be age-specific. This article presents a series of 32 patients aged 1.5-14 years, with compound injuries of the upper limb that have been treated in our hospital during the period of the last 6 years. Ten of the above cases involved major vascular lesions that required revascularization or replantation. The injuries were classified according to the SATT (Severity, Anatomy, Topography, Type) classification system. This study shows that the outcome of compound upper limb injuries is age-related, while the SATT classification system is a valuable tool in the decision making process. Further research should be undertaken to determine age group-specific indications for the management of compound upper limb injuries, based on the SATT classification system.

Case report and literature review of the outcome following reimplantation of the arm

“…It is generally accepted that young age is a strong positive predictive factor with regard to performing reimplantation, 11 provided that the amputated part is not extensively crushed. 13 Severe upper limb injuries differ in prognosis between children and adults. 13 The major factor for the difference is the superior neural regeneration in part because of the shorter distances involved in nerve regeneration.…”

“… 13 Severe upper limb injuries differ in prognosis between children and adults. 13 The major factor for the difference is the superior neural regeneration in part because of the shorter distances involved in nerve regeneration. 6 13…”

“…Kleinert and Graham 7 found that children less than 9 years old had greater return of sensation. Since children also have better vascularity and bone healing, 13 there is almost unanimous agreement that reimplantation should be attempted at any level in the upper limb in children. 3 …”

Psychological and Social Consequences after Reconstruction of Upper Extremity Trauma: Methods of Detection and Management

“…98 ►Table 2 summarizes all the potential factors that can affect the outcome after the management of upper extremity trauma. [99][100][101][102][103][104][105][106]…”

“…Age of the patient Ignatiadis et al, 105 Jaquet et al, 69 Ruijs et al 70 Personality characteristics Marušič et al, 74 Matthews et al 93 Patient language Bot et al 67 Patient satisfaction Jackson et al, 75 Vranceanu and Ring, 77 Marks et al 80 Patient expectations Pomerance, 106 Becker et al 84 Cognitive capacity Rosén et al, 81 Boender et al 83…”