Abstract
Plain radiographs of the limbs were reviewed after replantation procedures following traumatic amputation in 5 patients at the wrist (2), mid-forearm (2) and knee (1). Following upper limb replantation, rapid development of osteopaenia was initially noted in the juxta-articular regions and metaphyses of the tubular bones of the hand. These changes were followed by diaphyseal cortical bone loss with evidence of subperiosteal, intracortical and endosteal bone resorption. Juxta-articular erosions developed at the margins of the small joints in the hand in all cases. Gradual resolution of bone changes was noted in 3 of the 4 cases where follow-up exceeded 5 years. Following lower limb replantation, there was no evidence of bone loss; however, severe neuropathic joint disease developed within 18 months and progressed over the following 9 years. We suggest that the radiographic changes observed after upper limb replantation reflect regional hyperaemia secondary to neurovascular damage, whilst the changes in the lower limb reflect a similar process in a limb subjected to weight bearing.
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Address reprint requests to: Department of Diagnostic Radiology, The Medical School, Stopford Building, University of Manchester, Oxford Rd, Manchester, M13 9PT, UK
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Jackson, A., Reilly, M. & Watson, S. Radiological appearances following limb replantation: a report of 5 cases. Skeletal Radiol. 21, 155–159 (1992). https://doi.org/10.1007/BF00242128
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DOI: https://doi.org/10.1007/BF00242128