Krukenberg procedure | Hacker News Reader

Krukenberg procedure

en.wikipedia.org

56 pointskoolba11 comments

This seems great, so why does the article state:

> It remains in use today for certain special cases but is considered controversial and some surgeons refuse to perform it.

I imagine there's a reason, but I hope its not "doesn't look good"

That does indeed seem to be the reason. As the article states it: "[T]he Krukenberg procedure's poor cosmesis makes it very rare [...]"

I'm sure self-image is a complicated consideration when someone is dealing with an amputation, I can't imagine trying to assess what the right choice for another person would be in that kind of situation. But surgeons straight out refusing to perform it seems extreme, based on the limited information provided in the article.

Making that assessment is a part of the surgeon's job.

Perhaps they realized at some point that many patients are enthusiastic for the procedure before it's done, but most grow to hate it afterwards -- and blame the surgeon for having done the procedure to them.

Any given patient will have had zero prior experience with complex physiological and psychological post-operative outcomes, whereas surgeons do (individually or collectively.) It seems fitting that they should share that, and discourage patients from having procedures if outcomes are mainly bad.

I imagine the reason is side effects, like additional long-term pain for the patient, compared to having to just a stump. As far as I know, those things are hard to predict (and mitigate if present).

But I'm by no means an expert, that's just a semi-educated guess.

I doubt this is that good for the joints in the elbow, as the two bones normally hinge in parallel. Patient self-image seems to be the main reason though.

Burkhard Heim, linked to at the bottom seems like a very interesting fellow.

His theories are still being researched, even though they are outside the mainstream: https://en.wikipedia.org/wiki/Heim_theory http://heim-theory.com/ http://www.hpcc-space.de/publications/documents/ExtendedHeim...

I wonder if you could use this surgery combined with a specialised prosthetic arm to create movable yet simple replacement hands.

Imagine a prosthetic arm with a hollow body and a hand that can open and close in a simple fashion. Run a hydraulic pipe from the artificial hand up to the pincer and secure the presses/cylinders at both ends.

When the amputee closes their pincer inside the artificial arm the prosthetic hand would then close. Differing amounts of pressure would allow the amputee to exert different amounts of pressure to grip, pick up and move objects.

Also, there would be no electronics to go wrong. Hydraulics are very stable, cheap and reliable technology!

Googling for "Krukenberg hands" gives an better image of what this procedure does. Basically it turns the forearm bones into two very long stiff fingers.

Bit of a flippant tone, but I found this video that shows a man who had the procedure after bilateral amputation following an accident with dynamite. He sounds pretty satisfied with it.

https://www.youtube.com/watch?v=t8yMNuNgxyo

There's also this video linked in the Wikipedia article, showing a man performing some common tasks – https://www.youtube.com/watch?v=2_ChitAgshk

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