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Digit and hand replantation.

Alexandros E Beris1, Marios G Lykissas, Anastasios V Korompilias

  • 1Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Ioannina, Greece. aberis@cc.uoi.gr

Archives of Orthopaedic and Trauma Surgery
|December 17, 2009
PubMed
Summary

Microsurgery enables replantation of amputated parts like fingers, restoring circulation and function. Careful patient selection and management are crucial for optimal outcomes in digit and hand replantation.

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Area of Science:

  • Microsurgery
  • Reconstructive Surgery
  • Trauma Surgery

Background:

  • Microsurgery has advanced significantly over 45 years.
  • Replantation of amputated parts, including digits and hands, is now widely possible.
  • Successful replantation restores circulation, function, and aesthetics.

Purpose of the Study:

  • To outline the goals of digit and hand replantation.
  • To identify critical factors influencing replantation outcomes.
  • To detail the essential components of replantation management.

Main Methods:

  • Meticulous preoperative assessment and planning.
  • Application of microsurgical techniques for repairing bone, vessels, nerves, and tendons.
  • Comprehensive postoperative care and evaluation.

Main Results:

  • Replantation aims to restore circulation, function, and sensation.
  • Key outcome determinants include injury type/level, ischemia time, patient factors (diabetes, age, sex, smoking).
  • Primary repair of structures is preferred, with exceptions for nerve gaps or avulsions.

Conclusions:

  • Strict patient selection and experienced microsurgical management are vital for successful replantation.
  • Postoperative care and evaluation are mandatory to prevent complications.
  • Further reconstructive surgery may be necessary to optimize functional results.