Krukenberg procedure

Surgical procedure to convert a forearm stump into a pincer

Krukenberg Procedure

The Krukenberg procedure is a surgical technique designed to convert a forearm stump into a functional pincer, allowing individuals with forearm amputations to gain improved grip and dexterity. This procedure is particularly beneficial for bilateral amputees who require enhanced manual dexterity for daily activities.

Diagram of the Krukenberg procedure

History

The Krukenberg procedure was first described by the German surgeon Hermann Krukenberg in 1917. It was initially developed to assist World War I veterans who had lost their hands in combat. The procedure gained popularity due to its ability to provide a functional alternative to prosthetic limbs, especially in resource-limited settings.

Indications

The Krukenberg procedure is indicated for patients with:

• Bilateral forearm amputations
• Intact radius and ulna
• Adequate soft tissue coverage
• Motivation and ability to undergo rehabilitation

Surgical Technique

The procedure involves the following steps:

1. Incision and Exposure: A longitudinal incision is made along the forearm stump to expose the radius and ulna. 2. Separation of Bones: The radius and ulna are carefully separated, creating a space between them. 3. Formation of Pincer: The separated bones are shaped to form a pincer-like structure, with the radius acting as the thumb and the ulna as the fingers. 4. Soft Tissue Adjustment: Soft tissues are adjusted to ensure adequate coverage and mobility of the newly formed pincer. 5. Closure: The incision is closed, and the patient is placed in a splint to allow for healing.

Rehabilitation

Postoperative rehabilitation is crucial for the success of the Krukenberg procedure. Patients undergo extensive physical therapy to learn how to use their new pincer effectively. This includes exercises to improve strength, range of motion, and coordination.

Advantages

• Provides a functional grip without the need for external prosthetics
• Allows for sensory feedback through the skin
• Can be performed in settings with limited access to advanced prosthetic technology

Disadvantages

• Aesthetic concerns due to the appearance of the forearm
• Requires significant rehabilitation and patient motivation
• Limited to patients with specific anatomical conditions

Related pages

• Amputation
• Prosthetics
• Rehabilitation (neuropsychology)