Presentation
Mangled right upper extremity due to a motor vehicle collision.
Patient Data
The radiograph indicates a traumatic amputation of the right upper extremity at the level of the mid humeral diaphysis. Tourniquet is noted above the level of the amputation.
Case Discussion
Trauma is the most common cause for upper extremity loss 1. In transhumeral amputations, the remaining length of the humerus influences functional status 2. The ideal level is 4-5 cm proximal to the elbow joint. However, if the amputation is more proximal, then at least 5-7 cm of residual length is necessary for proper glenohumeral mechanics and prosthesis use 3.
In this case, the radiograph shows a traumatic amputation of the right upper extremity at the level of the mid humeral diaphysis. Subsequently, the brachial artery was ligated, approximately 3-4 cm of the humerus was surgically resected to smooth margins, and the wound was eventually closed.
Case submitted by Andrew Pasion in collaboration with Caleb Bhatnagar (medical student at Loyola University Chicago).
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