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Forequarter Amputation
Forequarter amputation is amputation of the arm, scapula and clavicle. It is usually performed as a last resort to remove a cancer, but decreasingly so as limb-sparing operations improve. Surgical technique The rhomboid muscles, trapezius, levator scapulae and latissimus dorsi are transected. The neurovascular bundle consisting of the axillary artery, axillary vein and brachial plexus is ligated and cut. The area of the chest left exposed is then normally covered with a split-thickness skin graft. Society In 2008, David Nott, a British vascular surgeon in the Democratic Republic of the Congo with Médecins Sans Frontières, performed a forequarter amputation to save the life of a 16-year-old boy, whose arm had been severed by an injury. He was left with a gangrenous Gangrene is a type of tissue death caused by a lack of blood supply. Symptoms may include a change in skin color to red or black, numbness, swelling, pain, skin breakdown, and coolness. The feet and hands ...
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Amputation
Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventive surgery for such problems. A special case is that of congenital amputation, a congenital disorder, where fetal limbs have been cut off by constrictive bands. In some countries, amputation is currently used to punish people who commit crimes. Amputation has also been used as a tactic in war and acts of terrorism; it may also occur as a war injury. In some cultures and religions, minor amputations or mutilations are considered a ritual accomplishment. When done by a person, the person executing the amputation is an amputator. The oldest evidence of this practice comes from a skeleton found buried in Liang Tebo cave, East Kalimantan, Indonesian Borneo dating back to at least 31,000 years ago, where it was done when ...
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Scapula
The scapula (plural scapulae or scapulas), also known as the shoulder blade, is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone). Like their connected bones, the scapulae are paired, with each scapula on either side of the body being roughly a mirror image of the other. The name derives from the Classical Latin word for trowel or small shovel, which it was thought to resemble. In compound terms, the prefix omo- is used for the shoulder blade in medical terminology. This prefix is derived from ὦμος (ōmos), the Ancient Greek word for shoulder, and is cognate with the Latin , which in Latin signifies either the shoulder or the upper arm bone. The scapula forms the back of the shoulder girdle. In humans, it is a flat bone, roughly triangular in shape, placed on a posterolateral aspect of the thoracic cage. Structure The scapula is a thick, flat bone lying on the thoracic wall that provides an attachment for three groups of muscles: int ...
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Clavicle
The clavicle, or collarbone, is a slender, S-shaped long bone approximately 6 inches (15 cm) long that serves as a strut between the shoulder blade and the sternum (breastbone). There are two clavicles, one on the left and one on the right. The clavicle is the only long bone in the body that lies horizontally. Together with the shoulder blade, it makes up the shoulder girdle. It is a palpable bone and, in people who have less fat in this region, the location of the bone is clearly visible. It receives its name from the Latin ''clavicula'' ("little key"), because the bone rotates along its axis like a key when the shoulder is abducted. The clavicle is the most commonly fractured bone. It can easily be fractured by impacts to the shoulder from the force of falling on outstretched arms or by a direct hit. Structure The collarbone is a thin doubly curved long bone that connects the arm to the trunk of the body. Located directly above the first rib, it acts as a strut to kee ...
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Limb-sparing Techniques
Limb-sparing techniques, also known as limb-saving or limb-salvage techniques, are performed in order to preserve the look and function of limbs. Limb-sparing techniques are used to preserve limbs affected by trauma, arthritis, cancers such as high-grade bone sarcomas, and vascular conditions such as diabetic foot ulcers. As the techniques for chemotherapy, radiation, and diagnostic modalities improve, there has been a trend toward limb-sparing procedures to avoid amputation, which has been associated with a lower 5-year survival rate and cost-effectiveness compared to limb salvage in the long-run. There are many different types of limb-sparing techniques, including arthrodesis, arthroplasty, endoprosthetic reconstruction, various types of implants, rotationplasty, osseointegration limb replacement, fasciotomy, and revascularization. Arthrodesis Arthrodesis is the surgical immobilization of bones within a joint to promote fusion of the joint. Arthrodesis is performed most commonly ...
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Springer Science+Business Media
Springer Science+Business Media, commonly known as Springer, is a German multinational publishing company of books, e-books and peer-reviewed journals in science, humanities, technical and medical (STM) publishing. Originally founded in 1842 in Berlin, it expanded internationally in the 1960s, and through mergers in the 1990s and a sale to venture capitalists it fused with Wolters Kluwer and eventually became part of Springer Nature in 2015. Springer has major offices in Berlin, Heidelberg, Dordrecht, and New York City. History Julius Springer founded Springer-Verlag in Berlin in 1842 and his son Ferdinand Springer grew it from a small firm of 4 employees into Germany's then second largest academic publisher with 65 staff in 1872.Chronology
". Springer Science+Business Media.
In 1964, Springer expanded its business internationally, o ...
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Neurovascular Bundle
A neurovascular bundle is a structure that binds nerves and veins (and in some cases arteries and lymphatics) with connective tissue so that they travel in tandem through the body. Structure There are two types of neurovascular bundles: superficial bundles and deep bundles. As arteries do not travel within the superficial fascia (loose connective tissue under the skin), superficial neurovascular bundles differ from deep neurovascular bundles in both composition and function. Superficial bundles Superficial neurovascular bundles do not include arteries, and consist primarily of capillaries and nerves. Because capillaries function as the sites for substance exchange between interstitial fluid and blood, they tend to have large surface area and short diffusion path. Normally, capillaries consist of a central lumen lined with an endothelium, a single layer of smooth epithelial cells. Deep bundles Deep neurovascular bundles, which often include arteries, have a more complicate ...
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Axillary Artery
In human anatomy, the axillary artery is a large blood vessel that conveys oxygenated blood to the lateral aspect of the thorax, the axilla (armpit) and the upper limb. Its origin is at the lateral margin of the first rib, before which it is called the subclavian artery. After passing the lower margin of teres major it becomes the brachial artery. Structure The axillary artery is often referred to as having three parts, with these divisions based on its location relative to the Pectoralis minor muscle, which is superficial to the artery. * First part – the part of the artery superior to the pectoralis minor * Second part – the part of the artery posterior to the pectoralis minor * Third part – the part of the artery inferior to the pectoralis minor. Relations The axillary artery is accompanied by the axillary vein, which lies medial to the artery, along its length. In the axilla, the axillary artery is surrounded by the brachial plexus. The second part of the axi ...
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Axillary Vein
In human anatomy, the axillary vein is a large blood vessel that conveys blood from the lateral aspect of the thorax, axilla (armpit) and upper limb toward the heart. There is one axillary vein on each side of the body. Structure Its origin is at the lower margin of the teres major muscle and a continuation of the brachial vein. This large vein is formed by the brachial vein and the basilic vein. At its terminal part, it is also joined by the cephalic vein. Other tributaries include the subscapular vein, circumflex humeral vein, lateral thoracic vein and thoraco-acromial vein. It terminates at the lateral margin of the first rib, at which it becomes the subclavian vein. It is accompanied along its course by a similarly named artery, the axillary artery In human anatomy, the axillary artery is a large blood vessel that conveys oxygenated blood to the lateral aspect of the thorax, the axilla (armpit) and the upper limb. Its origin is at the lateral margin of the firs ...
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Brachial Plexus
The brachial plexus is a network () of nerves formed by the anterior rami of the lower four cervical nerves and first thoracic nerve ( C5, C6, C7, C8, and T1). This plexus extends from the spinal cord, through the cervicoaxillary canal in the neck, over the first rib, and into the armpit, it supplies afferent and efferent nerve fibers the to chest, shoulder, arm, forearm, and hand. Structure The brachial plexus is divided into five ''roots'', three ''trunks'', six ''divisions'' (three anterior and three posterior), three ''cords'', and five ''branches''. There are five "terminal" branches and numerous other "pre-terminal" or "collateral" branches, such as the subscapular nerve, the thoracodorsal nerve, and the long thoracic nerve, that leave the plexus at various points along its length. A common structure used to identify part of the brachial plexus in cadaver dissections is the M or W shape made by the musculocutaneous nerve, lateral cord, median nerve, medial cord, and u ...
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Skin Graft
Skin grafting, a type of graft surgery, involves the transplantation of skin. The transplanted tissue is called a skin graft. Surgeons may use skin grafting to treat: * extensive wounding or trauma * burns * areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans * specific surgeries that may require skin grafts for healing to occur - most commonly removal of skin cancers Skin grafting often takes place after serious injuries when some of the body's skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: reducing the course of treatment needed (and time in the hospital), and improving the function and appearance of the area of the body which receives the skin graft. There are two types of skin grafts: * The more common type involves removing a thin layer of skin from a healthy part of the body (the donor section) - like peeling a potato. * A fu ...
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Democratic Republic Of The Congo
The Democratic Republic of the Congo (french: République démocratique du Congo (RDC), colloquially "La RDC" ), informally Congo-Kinshasa, DR Congo, the DRC, the DROC, or the Congo, and formerly and also colloquially Zaire, is a country in Central Africa. It is bordered to the northwest by the Republic of the Congo, to the north by the Central African Republic, to the northeast by South Sudan, to the east by Uganda, Rwanda, and Burundi, and by Tanzania (across Lake Tanganyika), to the south and southeast by Zambia, to the southwest by Angola, and to the west by the South Atlantic Ocean and the Cabinda exclave of Angola. By area, it is the second-largest country in Africa and the 11th-largest in the world. With a population of around 108 million, the Democratic Republic of the Congo is the most populous officially Francophone country in the world. The national capital and largest city is Kinshasa, which is also the nation's economic center. Centered on the Congo Basin, t ...
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Médecins Sans Frontières
(MSF; pronounced ), also known as Doctors Without Borders, is a humanitarian medical non-governmental organisation (NGO) or charity of French origin known for its projects in conflict zones and in countries affected by endemic diseases. Main areas of work include diabetes, drug-resistant infections, HIV/AIDS, hepatitis C, tropical and neglected diseases, tuberculosis, vaccines and COVID-19. In 2019, the charity was active in 70 countries with over 35,000 personnel; mostly local doctors, nurses and other medical professionals, logistical experts, water and sanitation engineers, and administrators. Private donors provide about 90% of the organisation's funding, while corporate donations provide the rest, giving MSF an annual budget of approximately US$1.63 billion. MSF was founded in 1971, in the aftermath of the Biafran famine of the Nigerian Civil War, by a small group of French doctors and journalists who sought to expand accessibility to medical care across national ...
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