11/7/2014Professor Freih Abuhassan -

University of Jordan 1

Hand amputation

11/7/2014 2Professor Freih Abuhassan -

University of Jordan

11/7/2014 3Professor Freih Abuhassan -

University of Jordan

= Black parts are most important to preserve,

= Oblique lines indicate less important parts,

= White areas are troublesome and should be amputated. 11/7/2014 4

Professor Freih Abuhassan -

University of Jordan

In amputations of many digits,

pinch and grasp are the chief

functions to be preserved

11/7/2014 5Professor Freih Abuhassan -

University of Jordan

11/7/2014 6Professor Freih Abuhassan -

University of Jordan

1-The amount of skin lost,

2- The depth of the soft tissue defect,

and whether the phalanx has been exposed

or even partially amputated

11/7/2014 7Professor Freih Abuhassan -

University of Jordan

11/7/2014 8Professor Freih Abuhassan -

University of Jordan

KUTLER V-Y ADVANCEMENT FLAPS

11/7/2014 9Professor Freih Abuhassan -

University of Jordan

ATASOY ADVANCEMENT FLAPS

11/7/2014 10Professor Freih Abuhassan -

University of Jordan

CROSS FINGER FLAPS

11/7/2014 11Professor Freih Abuhassan -

University of Jordan

11/7/2014 12Professor Freih Abuhassan -

University of Jordan

THENAR FLAP

11/7/2014 13Professor Freih Abuhassan -

University of Jordan

LOCAL N.V ISLAND GRAFT

11/7/2014 14Professor Freih Abuhassan -

University of Jordan

at PIPJ= at a more proximal level the remaining

stump is useless and may hinder pinch

between the thumb and middle finger.

= decrease grip by 20%

= loss of precision handling skills

= control of hammers is decreased

11/7/2014 15Professor Freih Abuhassan -

University of Jordan

11/7/2014 16Professor Freih Abuhassan -

University of Jordan

The prox. phalanx is import. functionally

Its absence

1- makes a hole through which small objects

can drop when the hand is used as a cup

or in a scooping maneuver.

2-makes the remaining fingers tend to

deviate toward the midline of the hand.

11/7/2014 17Professor Freih Abuhassan -

University of Jordan

11/7/2014 18Professor Freih Abuhassan -

University of Jordan

11/7/2014 19Professor Freih Abuhassan -

University of Jordan

At least length of proximal phalanx

& ½ middle phalanx needed to be

preserved, otherwise entire digit

removed.

In ThumbAny amount of length preserved.

11/7/2014 20Professor Freih Abuhassan -

University of Jordan

11/7/2014 21Professor Freih Abuhassan -

University of Jordan

11/7/2014 22Professor Freih Abuhassan -

University of Jordan

Thumb reconstruction at various levels.

11/7/2014 23Professor Freih Abuhassan -

University of Jordan

11/7/2014 24Professor Freih Abuhassan -

University of Jordan

11/7/2014 25Professor Freih Abuhassan -

University of Jordan

Osteoplastic reconstruction of thumb.

11/7/2014 26Professor Freih Abuhassan -

University of Jordan

11/7/2014 27Professor Freih Abuhassan -

University of Jordan

Preferred over BE operation as

pronation & supination preserved.

11/7/2014 28Professor Freih Abuhassan -

University of Jordan

11/7/2014 29Professor Freih Abuhassan -

University of Jordan

11/7/2014 30Professor Freih Abuhassan -

University of Jordan

As much preservation

as possible - not < 5 cm.

11/7/2014 31Professor Freih Abuhassan -

University of Jordan

End of humerus can be gripped by

prosthesis - advantage.

11/7/2014 32Professor Freih Abuhassan -

University of Jordan

Level should be below level of axillary

fold & proximal at least 5 cm to elbow

(to allow prosthesis fitting).

11/7/2014 33Professor Freih Abuhassan -

University of Jordan

A/Elbow

11/7/2014 34Professor Freih Abuhassan -

University of Jordan

11/7/2014 35Professor Freih Abuhassan -

University of Jordan

Head preserved to maintain

contour of shoulder.

11/7/2014 36Professor Freih Abuhassan -

University of Jordan

Removal of UL with clavicle, scapula

& related muscles.

(inter-scapulo-thoracic amputation)

11/7/2014 37Professor Freih Abuhassan -

University of Jordan

11/7/2014 38Professor Freih Abuhassan -

University of Jordan

11/7/2014 39

Professor Freih Abuhassan -

University of Jordan

11/7/2014 40Professor Freih Abuhassan -

University of Jordan

11/7/2014 41Professor Freih Abuhassan -

University of Jordan

11/7/2014 42Professor Freih Abuhassan -

University of Jordan

11/7/2014 43Professor Freih Abuhassan -

University of Jordan

11/7/2014 44Professor Freih Abuhassan -

University of Jordan

11/7/2014 45Professor Freih Abuhassan -

University of Jordan

11/7/2014 46Professor Freih Abuhassan -

University of Jordan

11/7/2014 47Professor Freih Abuhassan -

University of Jordan