Above elbow limb replantation: functional results

Seven patients with a complete transhumeral limb amputation had their limb replanted. In all seven limbs the mechanism of injury was avulsion, and the ischemic time was relatively prolonged, with a range of 10 to 14 hours. The five patients with surviving limbs achieved useful elbow control. Of these patients, two achieved useful distal function to the wrist and hand and one had a below elbow amputation. All but one patient required multiple secondary operative procedures, with an average of 2.8 procedures for those patients with surviving limbs. We did not encounter any significant life-threatening problems. Less serious complications were encountered in all but three patients during the postoperative period. We suggest that limb replantation at transhumeral levels may be of value for recovery of elbow function in most of these patients. In some instances, this may permit the conversion of an above elbow level amputation to a functional below elbow level. In a few patients, recovery of useful hand function may be achieved.