Forequarter amputation (FQA) is a surgical treatment of tumors in the upper extremity and shoulder girdle that infiltrate the neurovascular. Forequarter or inter scapulothoracic amputation is an uncommonly performed operation for malignant tumours involving the proximal end of humerus and the. Forequarter amputation combined with chest wall resection is a rarely performed procedure. Six patients were treated for advanced malignancies with this.
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He underwent forequarter amputation via an anterior approach Figure 4.
The amputation stump itself is of no inherent functional value at these levels because even the ability to grasp or stabilize large objects between the residual limb and thorax will be eliminated. It is usually performed as a last resort to remove a cancer, but decreasingly so as limb-sparing operations improve.
You can also find us on social media:. The indications include but are not limited to:. Replantation may occasionally be considered when the skeletal and neural injuries allow repair or reconstruction, and probably then only in the very young patient in whom some useful neurologic and functional recovery is possible.
Ultimately wound coverage was obtained via vacuum assisted closure Figure 6 followed by split thickness skin grafting 2 weeks later. Natl Med J China. Can J Plast Surg. Forequarter amputation for high-grade malignant tumours of the shoulder girdle. Unfortunately the patient had a fall several weeks postoperatively and this caused a wound dehiscence along the flap margin. Click for more information about this text.
Again treatment options were limited by previous radiation to the axillary region. Then come onto chest wall immed anterior and divide Pec maj origin from remaining clav. Divide all muscles foreqiarter to scapula. He developed superficial wound infection managed successfully with appropriate antibiotics.
The tumour was adherent to the chest wall.
Forequarter amputation is amputation of the armscapula and clavicle. Development of fasciocutaneous skin flaps for primary closure. The clavicle was carefully elevated to expose the subclavian artery, corequarter and brachial plexus. We found it convenient to ligate the bundle under direct vision as a last step after completing the anterior dissection as well.
InPaul Berger published a amputaion description of an anterior approach xmputation forequarter amputation 1. Nevertheless, multiple reconstruction techniques with fasciocutaneous flaps based on the amputated extremity have been described, and they range from small radial flaps to large flaps depending on the remnant defect. Inalthough clinically well the patient developed a 3cm mass in his left axilla and excisional biopsy confirmed amputatiob cell carcinoma. Forequarter interscapulothoracic amputation was first performed by Ralph Cuming in Palliative forequarter amputation for metastatic carcinoma to the shoulder girdle region: April 10, ; Published Date: Resection and immediate reconstruction with a free radial forearm flap extended from the distal third of the arm to the midpalmar region, taking the humeral artery and the cephalic vein as a main peddicle.
Immediate, early and late amputatlon management of upper limb amputation. The dissection was extended over the chest in order to obtain the widest possible margin. Physical examination revealed a hard tender rounded mass of about 25 cm around the right upper arm with prominent veins over the skin.
The posterior approach was described by Littlewood aputation 1. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics.
forequarterr Your hand sweeps behind scapula. March 18, ; Accepted Date: Post-operatively, the patient was hemodynamically stable and did well initially. Campbell’s operative orthopaedics, 7th ed.
Forequarter amputation – Wikipedia
The histopathology diagnosis was fibrosarcoma. The humeral vein fkrequarter anastomosed end-to-side to the subclavian vein. Next, the chest wall attachments of the pectoralis major and minor were divided. Support Center Support Center. The details of surgical technique are well delineated in the standard textbooks and monographs on amputation. Electrically powered prostheses for the adult with an upper limb amputation.
Forequarter Amputation for Tumours of the Upper Extremity
Although the patient suffered a post-operative wound complication, in our opinion, his forequafter of suffering a catastrophic complication would have been much higher if pre-embolization forequartrr not been performed.
Palliative if not curative treatment was necessary. Unfortunately, over the next two weeks his flap margins began to show ischemic changes and revision surgery was required for flap debridement. Research articles conducted on animals, will not be considered for processing or publication in the JPMA.