Biemer used a classification for amputations involving the hand for comparison of functional results after replantation surgery. The author is from the Technical University in Munich.
|
Thumb |
Other Fingers |
Location |
Zone |
|
from base of fingernail |
from base of fingernail |
distal finger |
I |
|
from distal PIP joint |
from distal PIP joint |
distal finger |
II |
|
from metacarpal to proximal phalangeal joint |
from metacarpal to proximal phalangeal joint |
finger |
III |
|
NA |
from mid-metacarpal bone (distal to main arterial loop) |
midhand |
IV |
|
from wrist |
from wrist |
hand |
V |
Mechanisms of injury:
(1) guillotine
(2) crushing
(3) avulsion
(4) mixed
(5) degloving
|
Amputation |
Connections |
|
total |
no remaining connection with the body |
|
subtotal, Type I |
bone connection intact |
|
subtotal, Type II |
extensor tendon connection intact |
|
subtotal, Type III |
flexor tendon connection intact |
|
subtotal, Type IV |
nerve connection intact |
|
subtotal, Type V |
skin or soft tissue connection intact |
Features of a subtotal amputation:
(1) The main vascular connections are interrupted and there is no evidence of circulation.
(2) Most of the functional structures must be separated.
(3) The soft tissue connection should be less than 25% of the part's circumference.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
