PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Case Study

Volume 3 Issue 1

Near Hand Amputation: A Report of Four Cases

Anthony Sabo Ezekiel*, Shaphat Ibrahim, Kefas J Bwala and Simon J Yiltok

December 14, 2023

DOI : 10.56831/PSSRP-03-079


Background: The hand is an important part of the body that helps man express his thought and skills to the physical world. It is very essential to both function and cosmesis. Loss of this important body part can be devastating to the victim. We defined near total hand amputation as injury between the wrist and musculotendinous junction of extrinsic muscles of the hand transecting extensor and flexor compartment structures either passing through the wrist joint or transecting the two bones of the forearm leaving the hand attached to strip(s) of soft tissue. There are few reported cases of this type of injuries and most often completion amputation is done with loss of the hand. This study reports the outcome of near total hand amputation repair without revascularization in four patients seen and managed in Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) in 2020. This shows that with basic surgical equipment, hand salvage surgeries can be done with very good outcome. Methods: Consecutive Patients with near total hand amputation seen and managed in ATBUTH in 2020 were recruited for this case series report. Results: Four patients with such injury were seen and managed within four months in 2020. Three had their hands repaired with very good outcome while one had a completion amputation. Three out of the four had injury to their right hand, all four were right-handed males in their third decade of life and injuries commenced from ulnar borders. Majority had transection of virtually all structures except branches of major vessels. Conclusion: The study shows that a number of near hand amputation can be salvaged with basic equipment with significant functional and cosmetic outcome.

Keywords: Near amputation; hand; reconstruction; Without revascularization


  1. Taylor CL and Schwarz RJ. “The anatomy and mechanics of the human hand”. Artif Limbs 2.2 (1955): 22-35.
  2. Bueno Jr RA., et al. “Replantation current concepts and outcomes”. Clin Plastic Surg 41 (2014): 385-395.
  3. Alphonsus CKS. “Principles in the management of a mangled hand”. Indian J Plast Surg 44 (2011): 219-226.
  4. Lakmali MGN., et al. “Pattern and distribution of defence injuries: A multi-center study on clinical and autopsy findings”. Medico-Legal Journal of Sri Lanka 4.1 (2016): 1-10.
  5. Griffin M., et al. “Management of extensor tendon injuries”. The open Orthopaedics Journal 6.S1:M4 (2012): 36-42.
  6. Olaitan PB and Jiburum BC. “A Review of Amputation of 106 Hand Digits”. Nigerian Journal of Orthopaedics and Trauma 7.1 (2008): 3-6.
  7. Otei MO, Ekpo OO and Isiwele E. “Spaghetti Wrist Injury: Epidemiology and Management in Calabar, Southern Nigeria”. IOSR-JDMS 16.7 (2017): 87-91.
  8. Yiltok SJ., et al. “The Spaghetti Wrist Injuries: Presentation and Treatment”. Nigerian journal of Orthopaedics and Trauma 11.2 (2014): 68-72.
  9. Nelson FR and Blauvelt CT. “Prosthetics and orthotics”. in Manual of Orthopaedics terminology, 7th ed Mosby, Maryland (2007): 173-190.
  10. Bender LF and Koch RD. “Meeting the challenge of partial hand amputations”. Orthotics and prosthesis 30.1 (1976): 3-11.
  11. Chattopadhyay S and Sukul B. “Pattern of defence injuries among homicidal victims”. Egyptian Journal of Forensic Sciences 3.3 (2013): 81-84.
  12. Hugar BS., et al. “Study of defense injuries in homicidal deaths; An autopsy study”. Journal of Forensic Legal Medicine 19 (2012): 207-210.
  13. Kaikici U, Ozkok MS and Osral M. “An autopsy evaluation of defense wounds in 195 homicidal deaths due to stabbing”. Journal of Forensic Science 34.4 (1994): 237-240.
  14. Cavadas PC, Thione A and Rubi C. “Hand Amputations at the Radiocarpal Level with Proximal Neuromuscular Avulsion”. J Hand Surg Am 41.1 (2016): 70-75.
  15. Lakmali MGN., et al. “Pattern and distribution of defence injuries: A multi-center study on clinical and autopsy findings”. Medico-Legal Journal of Sri Lanka 4.1 (2016): 1-10.