Krukenberg surgery

Krukenberg surgery

1. Krukenberg surgery

2. What is it? converting the forearm to forceps in which the radial ray acts against the ulnar ray We can compare the function of the reconstructed limb with the use of chopsticks It is helpful in patients with amputations , especially in surroundings where modern prosthetic services are unavailable .

3. According to Swanson, children with bilateral congenital amputation find the reconstructed limb much more useful than a mechanical prosthesis In children, it does not prevent the wearing of an ordinary prosthesis if desired.

4. Procedure Make a longitudinal incision on the flexor surface of the forearm slightly toward the radial side. Make a similar incision on the dorsal surface slightly toward the ulnar side, but on this surface elevate a V-shaped flap to form a web at the junction of the rays

5. Forearm muscles into 2 groups Radial Ulnar Radial wrist flexors and extensors Ulnar wrist flexors and extensors Radial half of the flexor digitorum sublimis Ulnar half of flexor digitorum Radial half of extensor digitorum Ulnar half of extensor digitorum Brachioradialis Palmaris longus Pronator teres

6. If the stump is too bulky or the wound is hard to close, We can resect the pronator quadratus , the flexor digitorum profundus , the flexor pollicis longus , the abductor pollicis longus , and the extensor pollicis brevis as necessary. Take care not to disturb the pronator teres .

7. Incise the interosseous membrane throughout its length along its ulnar attachment, without damaging the interosseous vessel and nerve . The radial and ulnar rays can be separated 6 to 12 cm at their tips. M otion at their proximal ends occurs at the radiohumeral and proximal radioulnar joints. The opposing ends of the rays should touch, if not, osteotomize the radius or ulna as necessary.

8. R adial ray T he adductors are pronator teres supinator flexor carpi radialis Radial half of the flexor digitorum sublimis and Palmaris longus . T he abductors are Brachioradialis extensor carpi radialis longus extensor carpi radialis brevis Radial half of the extensor digitorum communis and Biceps .

9. Ulnar ray The adductors are flexor carpi ulnaris ulnar half of the flexor digitorum sublimis Brachialis and Anconeus The abductors are extensor carpi ulnaris ulnar half of the extensor digitorum and triceps

10. Thank you