Transcarpal Amputation
- Retain flexion/extension of wrist
- Wrist flexor and extensor tendons are tenodesed to remaining carpus to allow for this
- Longer lever arm but harder to fit prosthesis
- Long full thickness palmar flap and shorter dorsal flap in 2:1 ratio
- Median/ulnar nerves sectioned + retract
- Radial nerve divided into fine filaments and each is sectioned
- Radial/ulnar arteries ligated
- Use finger tendons for bony coverage
Wrist disarticulation
- Similar to transcarpal amp but lose wrist flex/ext
- Can rasp prominence of styloid processes (maintain radial styloid height for prosthesis fitting though)
- Can doubly ligate medial/ulnar/SRN proximally in forearm to reduce neuroma chance
- Protect DRUJ + TFCC for normal pronation/supination
- Better for paediatrics — retains distal radial/ulnar physis for normal growth of stump and prevents terminal overgrowth
Author Contributions
Page written by Dr James Drummond