Forequarter Amputation

Resection of the arm with attached scapula and clavicle was first performed by Surgeon Cuming in the Royal Naval Hospital at Antigua in 1808 on a sailor hit in the shoulder by a cannon ball; he made a good recovery.100 Velpeau remarked that pull-off injuries of the arm (see Chapter 3) and shoulder disarticulations combined with part of the scapula, followed by healing, may have encouraged such surgery. and by 1840 he was able to report several cases, mainly for malignant disease.101 Surprisingly, Malgaigne and Farabeuf have nothing to say on the subject. Gross reported a few more cases but had no personal experience. In 1900, Bryant considered the operation tedious, attended by great loss of blood and difficulty in obtaining flaps to close the wound in malignant cases; for 51 recorded forequarter amputations, he said the mortality was 25%.102 In Little's analysis of 1000 consecutive amputees from World War I, only 1 underwent forequarter resection. Thomas and Haddan commented on its significant disfigurement and difficulty in fitting a prosthesis which has no function, although by restoring shoulder symmetry the patient's morale is boosted.103 In 1986, Vitali et al. commented that it was rarely performed, mainly for malignant tumours around the shoulder joint, and recommended Littlewood's posterior approach but gave no reference.104

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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