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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The level of bone transection is in the distal third of the forearm. This has traditionally been proposed to be of the most use to the patient as it preserves pronosupination of the forearm and provides adequate length for prosthesis fitting.
A D V E R T I S E M E N T
A fishmouth incision is made for skin flaps out of the zone of injury when possible. Flap length should be equal to one half the diameter of the forearm at the level of the bone cut. The subcutaneous tissue should be elevated cleanly off the fascia, with the skin, to ensure blood supply to the tissue edges. The superficial branches of both the radial and ulnar nerves should be located in the dorsal flap of a long forearm stump, placed on traction and buried deep to the wound edge.
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A D V E R T I S E M E N T
The muscle groups are divided and mobilized beyond the ends of the bone transection. The bone ends are smoothed with a rasp. The muscle ends should easily extend beyond the ends of the bone, or the bone should be shortened. The flexors are mobilized as superficial and deep groups, ligating and dividing blood vessels and nerves. The extensor mass is mobilized as a unit when possible, though the muscles can be separated along their fascial planes. The radial and ulnar arteries are dissected and ligated. The radial, ulnar and median nerves are dissected, placed on traction and sharply transected. Frequently the posterior and anterior interosseous arteries give rise to substantial bleeding that requires cauterization or ligation.
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This page was last modified on 6/15/2011.
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