Sensory recovery in replanted digits and transplanted toes: a review

A review of replanted digits has indicated that excellent sensory function can be recovered in replants that are distal, in which the mechanism of injury has been a sharp cut, in which the patient's age is young, and in cases where the patient receives postoperative sensory re-education. It appears that poor sensory recovery in replanted digits is most directly attributable to crush or avulsion type injuries and lack of sensory re-education in the postoperative period. The level of sensory recovery in toe-to-thumb transfers appears to be better than in the donor toe and better than in replanted digits. The explanation for this most likely lies in the sharp "mechanism of injury" in the toe-to-thumb transfer and in the "extra" postoperative rehabilitation such cases receive. Future improvements in recovery of sensation in replanted digits may come from increased use of nerve grafting in those digits that have been crushed or avulsed, and by instituting routine sensory re-education in the postoperative period.