Replantation proximal to the wrist

Technical aspects of importance in replantation proximal to the wrist are somewhat different from those involved with digital replantation. Re-establishing blood flow rapidly by insertion of an arterial shunt, meticulous debridement, stable internal fixation of fractures, fasciotomy, and re-examination of the tissue 48 to 72 hours after replantation are discussed. Indications and contraindications for replantation in addition to maximizing use of "spare parts" are illustrated.