Krukenberg procedure

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

The Krukenberg technique divides the two remaining bone of the forearm on in a gripping scissors. The technique separates this radius and ulna so that is created with amputations below the elbow or in cases of congenital absence of the hand, a scissors- like gripping ability, which is controlled by the pronator teres.

The requirements for a successful implementation are a stump of at least 10 cm in length from the tip of the elbow and no significant fracture of the selfsame. The success of the operation depends directly on the strength of the pronator teres, the sensitivity of the surrounding skin of the radius and ulna, the elbow mobility and Proximal radioulnar joint.

A good psychological preparation and the individual expectations and motivation of patients who have a significant role in the success of the intervention, although this is difficult to measure. The operation is now carried out in the absence of expensive prosthetic technology, most likely in developing countries. In the Western world the Krukenberg plastic is used almost exclusively in blind patients with bilateral amputations. Although Krukenberg plastic reaches only a small visual acceptability, they achieved but a high surface sensitivity and proprioception in the functioning arm stumps and thus allows good handling and feel. An implementation of the operation does not exclude that a medical prosthesis applied is that allows the patient to use both options.

Although surgery is rarely performed in modern times, since there are very good prostheses, a case from the Netherlands from 2002 has become known. The patient had received a mechanical prosthesis for a bilateral forearm amputation. She stopped suddenly, to use the artificial prosthesis and instead use the Unteramstümpfe as a gripping tool. To explain, they alleged that their was a great help in their work the feeling of surface sensitivity in the functioning arm stumps. An operation on a stump yielded an excellent result, both the medical as well as from the perspective of rehabilitation, the patient lives with her family, working as a painter and sculptor and was very pleased with the Krukenberg plastic. Another operation to create a gripping scissors on the second arm is in preparation

Known patients

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