Krukenberg plastic

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The Krukenberg plastic , also known as the Krukenberg surgery, is a surgical technique in which the forearm stump is divided into a kind of scissors. This technique was first described in 1917 by the surgeon Hermann Krukenberg and used during the First World War . Nowadays it is practiced only in a few cases and is rejected by some surgeons. In 1981, the year of the disabled , she was honored with two stamps in Bangladesh .

The Krukenberg technique divides the two remaining bones of the forearm into gripping scissors. The technique separates the ulna and radius in such a way that, in the case of amputations below the elbow or in cases of a hereditary lack of the hand, a scissor-like gripping option is created, which is controlled by the pronator teres muscle .

The prerequisites for a successful implementation are a stump at least 10 cm long from the tip of the elbow and no significant fracture of the same. The success of the operation depends directly on the strength of the pronator teres muscle, the sensitivity of the surrounding skin of the ulna and radius, the mobility of the elbows and the proximal radioulnar articulation .

Good psychological preparation and the patient's individual expectations and motivation play a key role in the success of the procedure, even if this is difficult to measure. Today, in the absence of expensive prosthetic technology , the operation is most likely to be performed in developing countries. In the western world, the Krukenberg plastic is almost exclusively used in blind patients with bilateral amputations. Even if the Krukenberg plastic only achieved a low level of optical acceptance, it still achieves a high level of proprioception and surface sensitivity in the functioning stumps of the arm and thus allows good handling and haptics . Performing the operation does not rule out the use of a medical prosthesis that enables the patient to use both options.

Although the operation is seldom performed nowadays, as there are very good prostheses, a case from the Netherlands from 2002 has become known. The patient had received a mechanical prosthesis after a bilateral forearm amputation. She suddenly stopped using the artificial prosthesis and began using the forearm stumps as a grasping tool instead. She explained that the feeling of superficial sensitivity in the functioning arm stumps was a great help in her tasks. An operation on an arm stump produced an excellent result, both from a medical and a rehabilitation point of view. The patient lives with her family, works as a painter and sculptor and is very satisfied with the Krukenberg sculpture. Another operation to create gripping scissors on the second arm is in preparation.

Known patients

The German physicist Burkhard Heim had Krukenberg sculptures on both sides due to an accident in May 1944 during the development of explosives, in which he lost both hands.

literature

  • Alfons Lob : The Krukenberg sculpture in peacetime . Springer, 1970
  • J. Freire, C. Schiappacasse, A. Heredia, JD Martina, JHB Geertzen: Functional results after a Krukenberg amputation . In: Prosthetics and Orthotics International . tape 29 , no. 1 , April 2005, ISSN  0309-3646 , p. 87-92 , PMID 16180381 (English, report on a Dutch woman ).

Web links

Commons : Krukenberg-Plastik  - Collection of pictures, videos and audio files