Long-Term Outcomes of Arm Replantation.

Area of Science:

• Microsurgery
• Orthopedic Surgery
• Reconstructive Surgery

Background:

• Microsurgery advances have increased arm replantation survival rates.
• Functional outcomes following arm replantation remain unpredictable.
• Secondary reconstructive procedures are often necessary after initial replantation.

Purpose of the Study:

• To systematically review the long-term functional outcomes of arm replantation.
• To evaluate the types, timing, and impact of secondary reconstructive procedures.
• To identify factors influencing the overall success of arm replantation.

Main Methods:

• Systematic review of English literature from PubMed, Embase, and CENTRAL databases.
• Inclusion of studies with successful arm replantation and >1 year follow-up.
• Extraction and analysis of clinical data, including functional outcomes and secondary surgeries.

Main Results:

• 79 arm replantations across 29 studies were analyzed.
• A total of 111 secondary procedures were performed, averaging 2.6 per patient.
• Nerve repair, muscle transfer, and tendon transfer were common secondary procedures; distal amputations and sharp-cut injuries yielded better outcomes.

Conclusions:

• Optimal functional outcomes are achievable in approximately 49.4% of arm replantation patients.
• Multiple secondary surgical interventions and prolonged recovery are frequently required.
• Amputation level and injury type significantly impact final functional results.