An Innovative Technique to Preserve Elbow Function During Replantation of an Amputation Near the Elbow Joint in an Infant

Abstract Bone shortening is performed during replantation of major crush avulsion amputations. It ensures fixation of healthy bone ends, helps avoid vein, nerve grafts, and additional soft tissue procedures, thereby reducing ischemia time. When amputations occur near joints, bone shortening may lead to joint loss. A 12-month-old infant suffered amputation just proximal to the articular surface of the humerus. The humerus fragment was small for any stable fixation and any shortening of the proximal segment would offer a vastly different cross section for rigid fixation. To preserve elbow joint, a 3 cm of humerus segment was osteotomized from the proximal segment. The resected bone segment was fixed as a free bone graft to the humeral distal articular surface with Kirschner wires. A 3-cm further shortening was done in the proximal segment and fixed to the distal side. The free bone segment survived as graft with bone union at both sides with joint preservation.