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Function Versus Aesthetic: Arm Reconstruction After Land Mine Explosion

Tragically, land mines injure between 15,000 to 20,000 people each year. Some civilians see a metal object sticking out of the ground and attempt to pick it up and inspect it – the result is often loss of both hands and eyes.

The goal of rehabilitation after trauma is to restore as much independence as possible to patients. With loss of vision and no hands, self care, feeding, and donning/doffing arm prostheses can be very challenging. There is a procedure, known as the Krukenberg operation (named after Hermann Von Krukenberg, who first described it in 1917), that allows the forearm bones to be separated, using the muscle rotators that exist between them to create a pincer grasp. This procedure is not uncommonly used in India and Pakistan and does indeed return some degree of functional use to the arms.

At a recent Physical Medicine and Rehabilitation conference, this photograph was used to illustrate arm function after the Krukenberg operation.

Photo Credit: Dr. Heikki Uustal

Photo Credit: Dr. Heikki Uustal

It certainly presents a conundrum – should function trump aesthetics in all cases?

I’m not sure that I’d want this procedure, even if I lost my vision and both hands.

Would you?

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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