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Cross-Hand Replantation.

S Raja Sabapathy¹, Hari Venkatramani¹, Sanjai Ramkumar¹

¹Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India

|May 6, 2020

Summary

This summary is machine-generated.

This case study demonstrates successful emergency cross-hand replantation for severe bilateral upper extremity injuries. The patient regained independence in daily activities and employment, preferring the replanted hand over a prosthesis.

Keywords:

cross-hand replantation mangling injury replantation

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Area of Science:

Reconstructive Microsurgery
Orthopedic Surgery
Trauma Surgery

Background:

Combined major injury to both upper extremities is a rare and complex clinical scenario.
Cross-hand replantation is a potential, though infrequently considered, reconstructive option in such cases.
This report details an emergency cross-hand replantation at the wrist level.

Observation:

The surgical technique preserved wrist flexor and extensor tendon insertions at the recipient site.
Fascicle-specific nerve coaptations were meticulously performed.
Early active wrist and finger motion was facilitated by tenodesis.

Findings:

The patient achieved satisfactory functional outcomes, enabling independence in daily living activities.
Successful return to gainful employment was documented.
Long-term follow-up at 5 years showed continued functional use and patient preference for the replanted hand over a prosthesis.

Implications:

Cross-hand replantation can be a viable and effective reconstructive strategy for severe bilateral upper extremity trauma.
Preservation of tendon insertions and precise nerve coaptation are crucial for optimal functional recovery.
This approach offers a pathway to restore independence and employment for patients with devastating hand injuries.