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Transpositional replantation of digits. Case reports
A H Schwabegger1, C Harpf, A Rumer
1Department of Plastic and Reconstructive Surgery, Leopold Franzens University Innsbruck, Austria. Anton.Schwabegger@uibk.ac.at
Summary
Heterotopic digit replantation is feasible, offering results comparable to conventional methods. This technique prioritizes function over cosmetics, using the best-conditioned digits for optimal outcomes in complex amputations.
Area of Science:
- Microsurgery
- Reconstructive Surgery
- Hand Surgery
Background:
- Conventional digit replantation faces challenges in cases of multiple amputations or severe injuries.
- Heterotopic or transpositional replantation offers an alternative when direct replantation is not feasible.
Observation:
- In multiple digital amputations, not all digits may be replantable in their original position due to injury complexity.
- The selection of digits for replantation prioritizes those with the least tissue damage.
Findings:
- Heterotopic digit replantation is technically achievable with outcomes similar to conventional replantation.
- Functional outcome is the primary goal, followed by cosmetic results.
- Amputated long digits are preferentially used to reconstruct a non-replantable thumb over a long finger.
Implications:
- Transpositional replantation expands reconstructive options for severe hand trauma involving multiple digits.
- This technique allows for salvage of digits that might otherwise be unsalvageable.
- Successful application can significantly improve patient function and quality of life after traumatic amputation.