Forequarter amputation

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Forequarter amputation is amputation of the arm, scapula and clavicle. It is usually performed as a last resort to remove a cancer, but decreasingly so as limb-sparing operations improve.[1]

Surgical technique[edit]

The rhomboid muscles, trapezius, levator scapulae and latissimus dorsi are transected. The neurovascular bundle consisting of the axillary artery, axillary vein and brachial plexus is ligated and cut. The area of the chest left exposed is then normally covered with a split-thickness skin graft.[1]

In the news[edit]

In 2008, Mr. David Nott, a British vascular surgeon in the Democratic Republic of the Congo with Médecins Sans Frontières performed a forequarter amputation to save the life of a 16-year-old boy, whose arm had been severed by an injury. It is unclear whether the arm was bitten off by a hippopotamus[2] or destroyed by crossfire in the conflict.[3] He was left with a gangrenous stump and had a few days to live. It made the news because his colleague, Professor Meirion Thomas, sent pointers via SMS text message.[4] The text message included 10 steps to be followed and finished by saying, "Easy! Good luck."[5]


  1. ^ a b Malawer, Martin M.; Sugarbaker, Paul H. (2001), "Chapter 17 - Forequarter Amputation" (PDF), in Malawer, Martin M.; Sugarbaker, Paul H., Musculoskeletal Cancer Surgery Treatment of Sarcomas and Allied Diseases, Kluwer Academic Publishers, pp. 289–298, ISBN 978-0-7923-6394-1 
  2. ^ MSF: DRC: Amputation done after consultation via text messages (Last accessed Fri 19 Dec 2008.)
  3. ^ MSF surgeon describes the situation in Rutshuru, Congo (DRC) - news - MSF UK (Last accessed Fri 19 Dec 2008.)
  4. ^ "Surgeon saves boy's life by text". BBC News. BBC. 3 December 2008. Retrieved 19 December 2008. 
  5. ^ Text Messaging Surgical Instructions...It's "Easy! Good Luck" - Medgadget (Last accessed Fri 19 Dec 2008.)