Proximal Forearm Amputation

  • try & fashion anterior & posterior flaps of equal length
    • can get away with atypical flaps if necessary to avoid a higher amputation
  • reflect tissues proximally to the level of the bone section
  • just proximal to this, ligate & divide the major vessels
  • next identify the 3 major nerves, pull them distally, & section them proximally so their ends will retract
  • divide muscle bellies transversely distal to the level of bone section
  • divide radius & ulna transversely & smooth the edges
  • if end of stump is not distal to the insertion of biceps tendon, resect the distal 2.5 cm of the tendon to allow functional lengthening of the stump (elbow can still flex with brachialis)
  • close deep fascia & then skin, use drain