Digital and Upper Limb Replantation

Surgical indications of digital replantation are broadening, though there are controversial, including ischemia time limits, single digit amputated proximal to the flexor digitorum superficialis insertion, and replanting a fingertip. Complex digital replantation indeed pushes the limit of replantation possible by the most skilled of hands. The major energy and resources should be devoted to the vascular anastomosis. The functional results and sensory recovery are the challenges and future targets to get true success of replanted digits. The guiding principle is independence, preservation of function, and prevention of chronic pain that dictates operative candidates for replantation.