Mutilating electrotrauma: Case report

J 2010

Mutilating electrotrauma: Case report

KALOUDOVÁ, Yvona, Hana ŘIHOVÁ, Pavel BRYCHTA, Ivan SUCHÁNEK, Jiří KUČERA et. al.

Basic information

Original name

Mutilating electrotrauma: Case report

Authors

KALOUDOVÁ, Yvona (203 Czech Republic, guarantor), Hana ŘIHOVÁ (203 Czech Republic), Pavel BRYCHTA (203 Czech Republic), Ivan SUCHÁNEK (203 Czech Republic), Jiří KUČERA (203 Czech Republic), Ivo MENŠÍK (203 Czech Republic), Hana KRUPICOVÁ (203 Czech Republic) and Břetislav LIPOVÝ (203 Czech Republic)

Edition

Acta chir plast, Praha, 2010, 0001-5423

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

RIV identification code

RIV/00216224:14110/10:00043302

Organization unit

Faculty of Medicine

Keywords in English

high-voltage electrical current injuries compartment syndrome early fasciotomy amputation of extremities

Abstract

V originále

The passage of electric current through a human body causes polarization changes in cell membranes, which can possibly lead to the death of these cells. At the same time, electric energy is transformed to thermal energy, primarily in high resistance tissues. We present a case report of a 22-year-old male who was hit by an electric current with a voltage of 22 kV when he was working on a high-voltage overhead line tower. Primary treatment which included fasciotomies was completed two hours after the injury. Fasciotomies and revisions of all muscle groups were completed on the left upper extremity and right shank. On the right upper extremity fasciotomies were completed on the forearm. Retinaculum flexorum was cut in the area of both wrists. Despite the complex therapy including higher doses of a low-molecular-weight heparin, ischemization of the whole left upper extremity and distal part of right shank and foot occurred. On the sixth day after the injury it was necessary to amputate the right lower extremity in shank and on the eighth day after injury to amputate the left upper extremity below the shoulder, and on the fourteenth day, due to progressive ischemic necrosis, it was necessary to complete exarticulation of the left shoulder. The 45th day after the injury our team of micro-surgeons closed the defect of soft tissues in the distal part of right forearm and radial part of right hand by transferred parascapular fasciocutaneous flap. The right median nerve appeared to be necrotic in the distal part of forearm even at the day of injury. Four months after the injury the 12 cm long defect of the right median nerve was bypassed by a graft from the suralis nerve. Outpatient care followed as well as physical and psychological rehabilitation. The support of the family was admirable. One and a half years after the injury reconstruction of the right thumb flexor tendon was completed. Two years after the injury function of the right hand in terms of grip function was satisfactory (patient was able to complete pinch grip and sign). Gait with the prosthesis was very good.

Citovat

KALOUDOVÁ, Yvona, Hana ŘIHOVÁ, Pavel BRYCHTA, Ivan SUCHÁNEK, Jiří KUČERA, Ivo MENŠÍK, Hana KRUPICOVÁ and Břetislav LIPOVÝ. Mutilating electrotrauma: Case report. Acta chir plast. Praha, 2010, vol. 50, No 1, 11-15. ISSN 0001-5423.

@article{870478,
   author = {Kaloudová, Yvona and Řihová, Hana and Brychta, Pavel and Suchánek, Ivan and Kučera, Jiří and Menšík, Ivo and Krupicová, Hana and Lipový, Břetislav},
   article_location = {Praha},
   article_number = {1},
   keywords = {high-voltage electrical current injuries compartment syndrome early fasciotomy amputation of extremities},
   language = {eng},
   issn = {0001-5423},
   journal = {Acta chir plast},
   title = {Mutilating electrotrauma: Case report},
   volume = {50},
   year = {2010}
}

TY  - JOUR
ID  - 870478
AU  - Kaloudová, Yvona - Řihová, Hana - Brychta, Pavel - Suchánek, Ivan - Kučera, Jiří - Menšík, Ivo - Krupicová, Hana - Lipový, Břetislav
PY  - 2010
TI  - Mutilating electrotrauma: Case report
JF  - Acta chir plast
VL  - 50
IS  - 1
SN  - 00015423
KW  - high-voltage electrical current injuries compartment syndrome early fasciotomy amputation of extremities
N2  - The passage of electric current through a human body causes polarization changes in cell membranes, which can possibly lead to the death of these cells. At the same time, electric energy is transformed to thermal energy, primarily in high resistance tissues. We present a case report of a 22-year-old male who was hit by an electric current with a voltage of 22 kV when he was working on a high-voltage overhead line tower. Primary treatment which included fasciotomies was completed two hours after the injury. Fasciotomies and revisions of all muscle groups were completed on the left upper extremity and right shank. On the right upper extremity fasciotomies were completed on the forearm. Retinaculum flexorum was cut in the area of both wrists. Despite the complex therapy including higher doses of a low-molecular-weight heparin, ischemization of the whole left upper extremity and distal part of right shank and foot occurred. On the sixth day after the injury it was necessary to amputate the right lower extremity in shank and on the eighth day after injury to amputate the left upper extremity below the shoulder, and on the fourteenth day, due to progressive ischemic necrosis, it was necessary to complete exarticulation of the left shoulder. The 45th day after the injury our team of micro-surgeons closed the defect of soft tissues in the distal part of right forearm and radial part of right hand by transferred parascapular fasciocutaneous flap. The right median nerve appeared to be necrotic in the distal part of forearm even at the day of injury. Four months after the injury the 12 cm long defect of the right median nerve was bypassed by a graft from the suralis nerve. Outpatient care followed as well as physical and psychological rehabilitation. The support of the family was admirable. One and a half years after the injury reconstruction of the right thumb flexor tendon was completed. Two years after the injury function of the right hand in terms of grip function was satisfactory (patient was able to complete pinch grip and sign). Gait with the prosthesis was very good.
ER  -

KALOUDOVÁ, Yvona, Hana ŘIHOVÁ, Pavel BRYCHTA, Ivan SUCHÁNEK, Jiří KUČERA, Ivo MENŠÍK, Hana KRUPICOVÁ and Břetislav LIPOVÝ. Mutilating electrotrauma: Case report. \textit{Acta chir plast}. Praha, 2010, vol.~50, No~1, 11-15. ISSN~0001-5423.

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