- Krukenberg procedure
The Krukenberg procedure, first described in 1917 by surgeon
Hermann Krukenberg , is a surgical technique that converts a forearm stump into apincer . The procedure involves separating theulna andradius for below-elbowamputation s, and cases ofcongenital absence of the hand, to provide a pincerlike grasp that is motored by thepronator teres muscleEdwards, S.G. (2003). Wrist and Forearm Amputations. Retrieved from [http://www.emedicine.com/orthoped/topic620.htm] ] ] . The prerequisites for the operation are a stump over 10 cm long from the tip of theolecranon , no elbow contracture, and good psychological preparation and acceptance Garst, R.J. (1991). The Krukenberg Hand "The Journal of Bone and Joint Surgery" 385(3) Retrieved from [http://www.jbjs.org.uk/cgi/reprint/73-B/3/385] ] .Today, the procedure is mostly performed on patients in developing countries who lack the means to obtain expensive prostheses. In most cases, patients in developing countries actually prefer the pincers to prostheses. In the Western world, the Krukenberg procedure is reserved for blind patients with bilateral amputations, because it can provide the patient with tactile sensation., Wilhelmi, Brandon J. Digital Amputations. Retrieved from [http://www.emedicine.com/orthoped/topic75.htm] ]
The procedure preserves
proprioception andstereognosis in the functional stump to allow for effective maneuvering. Once this procedure is performed, it does not preclude the use of a functional prosthesis. Therefore, the patient is afforded the option to use either functional strategy.The success of the Krukenberg procedure depends directly on the strength of the
pronator teres , the sensibility of the skin surrounding bothulna andradius , elbow mobility, and mobility of theulna andradius at theproximal radioulnar joint . Individual patient expectations and motivations, although more difficult to assess, probably play a major role in outcomes as well.The German phycisist
Burkhard Heim had two Krukenberg hands as a result of a laboratory accident.References
External link
[http://www.jbjs.org.uk/cgi/reprint/73-B/3/385.pdf The Krukenberg Hand]
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