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April 1970

The Severely Injured Upper Limb: To Amputate or Reconstruct: That is the Question

Author Affiliations

Stanford, Calif
From the Department of Surgery, Stanford University School of Medicine, Stanford, Calif.

Arch Surg. 1970;100(4):382-392. doi:10.1001/archsurg.1970.01340220058011

Wherefore you shall cut off as little of that which is sound as you possibly can; yet so that you rather cut away that which is quicke; than leave behind anything that is perished, according to the advice of Celsus.1

It is precisely this philosophy expressed by Paré in the 16th century and its extension by recent advances in surgery that forms the basis for this paper. Paré continued, "Yet oft-times the commodity of the action of the rest of the part changes this counsell."1 This wise advice forms a basis for the still valid rule that salvage of a part which is useless either in its original role or as a contributor to restoration of another part is unsound judgment. Specific sites of election for amputation in both the upper and lower limbs have been established as valid through four centuries of surgery. Decisions on appropriate treatment

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