Successful replantation in ten-digit amputation

Area of Science:

• Microsurgery
• Reconstructive Surgery
• Trauma Surgery

Background:

• Ten-digit amputations are exceptionally rare due to varying digit lengths.
• This report focuses on a unique case of guillotine amputation involving all ten digits.

Observation:

• A 34-year-old printing house worker sustained a complete ten-digit amputation.
• Replantation surgery commenced 80 minutes post-admission and lasted seven hours, utilizing microsurgical techniques without grafts.
• Postoperative assessment revealed compromised circulation in specific digits, necessitating further surgical intervention including vascular anastomosis and vein grafting.

Findings:

• While most digits healed successfully, distal necrosis of the fourth digit required secondary amputation.
• Long-term radiographic evaluation (38 months) showed complete bony union without joint damage or significant malunion.
• The patient demonstrated good functional recovery, with functional daily activities, satisfactory pinch strength, and acceptable range of motion in hand joints.

Implications:

• This case highlights the feasibility of extensive digit replantation even in complex scenarios.
• Successful outcomes underscore the importance of timely microsurgical intervention and meticulous postoperative care.
• The patient's functional recovery provides valuable insights into long-term results following multiple digit replantations.