Separation of the hand from the rest of the upper limb.
The cause is usually traumatic although it may be secondary to elective surgery.
When amputation is performed in the context of surgery, blood vessels are tied off to prevent bleeding before bone and muscle are cut. The most frequent causes are diseases causing poor blood circulation, tumours, deformities, infections and/or gangrene.
When amputation occurs in the context of trauma, bleeding and tissue loss are usually greater. If the limb is torn off, bleeding can be massive and surgical repair very difficult. The most frequent causes are traffic accidents, work accidents and war injuries.
The treatment of choice is surgical and the priority is to save the finger if possible and to avoid bleeding and infection. Severe cases can lead to death of the patient if not controlled.
In cases of traumatic amputation, a tourniquet may be used to stop the bleeding until the surgical revision is performed. If the amputated limb and residual limb are properly cared for, reattachment of the amputated limb in a specialised centre may be considered.
- Tennent DJ, Wenke JC, Rivera JC, Krueger CA. Characterisation and outcomes of upper extremity amputations. Injury 2014; 45:965.
- Dougherty AL, Mohrle CR, Galarneau MR, et al. Battlefield extremity injuries in Operation Iraqi Freedom. Injury 2009; 40:772.
- Reavey PL, Stranix JT, Muresan H, et al. Disappearing Digits: Analysis of National Trends in Amputation and Replantation in the United States. Plast Reconstr Surg 2018; 141:857e.
- Maldonado AA, Kircher MF, Spinner RJ, et al. The role of elective amputation in patients with traumatic brachial plexus injury. J Plast Reconstr Aesthet Surg 2016; 69:311.
