The problems in replantation of limbs amputated through the upper arm region

We performed three replantations at the upper arm: two patients had severely crushed arms and one patient was at advanced age (50 years). One replanted arm was reamputated because of severe neuralgia 1 year, 3 months after replantation. In the other two cases, sensation was recovered to fingertips and powerful motion of the elbow joint was gained. However, pinch or grasp was impossible because of insufficient reinnervation to the extensor muscles. In replantation at the proximal region, recovery of motor function generally tends to be poor especially in a crush injury or in the case of advanced age. Therefore we consider that the decision about arm replantation at the upperarm region should be made more strictly than with a distal amputation.