Wrist level and proximal-upper extremity replantation

Area of Science:

• Orthopedic Surgery
• Microsurgery
• Hand Surgery

Background:

• Upper extremity replantation has evolved significantly since the 1960s.
• Techniques for digital replantation are well-established globally.
• Replantation proximal to the wrist presents unique surgical complexities.

Purpose of the Study:

• To highlight the distinct challenges of wrist-proximal replantation.
• To differentiate wrist-proximal replantation from digital replantation procedures.
• To underscore the advanced difficulties faced by hand surgeons in these specific cases.

Main Methods:

• Review of historical advancements in upper extremity replantation.
• Comparative analysis of surgical techniques for digital versus wrist-proximal replantation.
• Identification of unique anatomical and technical considerations for proximal replants.

Main Results:

• Wrist-proximal replantation remains a technically demanding procedure.
• Surgeons encounter specific difficulties not present in digital replantation.
• The complexity necessitates specialized approaches and expertise.

Conclusions:

• Despite overall advancements, wrist-proximal replantation continues to be a significant surgical challenge.
• Distinct surgical strategies are required for successful wrist-proximal limb salvage.
• Further refinement in techniques for these complex cases is warranted.