MAJOR CRUSH INJURY LEFT UPPER LIMB

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AFTER SURGIAL DEBRIDEMENT SHOWING LOSS OF MULTIPLE EXTENSOR MUSCLE POSTERIOR INTEROSSEOUS NERVE, WITH EXPOSED ELBOW JOINT

49 year old male met with a road traffic accident. Patient was driving a two wheeler which was overrun by a tipper  on 29.12.2010 at around 2.30 p.m. between Miryalguda and Damargidda Chevella mandal , Ranga Reddy distt. Andhra pradesh, India. Patient sustained extensive degloving injury to the left upper limb extending from the left mid arm to the left wrist region.

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LEFT UPPER LIMB RUN OVER BY A HEAVY VEHICLE
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INTRA OPERATIVE PICTURE SHOWING EXTENSIVE CONTAMINATION , DEGLOVING OF THE FOREARM SKIN
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LATISSIMUS DORSI FREE FLAP HARVESTED
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AFTER INSETTING OF MICROVASCULAR FREE LATISSIMUS DORS MUSCLE FLAP  – END TO SIDE TO BRACHIAL ARTERY AND END TO END TO VENAE COMITANTES
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IMMEDIATE POST OPERATIVE SPLINTING TO AVOID PRESSURE ON FREE TISSUE TRANSFER
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SKIN GRAFTING DONE AFTER 48 HOURS
PICTURE DURING FOLLOW UP – HEALED LEFT UPPER LIMB AFTER TWO SETTINGS OF SKIN GRAFTING  – DORSAL VIEW
FINGER FLEXION AFTER TWO YEAR
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