Cross-Hand Replantation (original) (raw)
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Oman Medical journal, 2011
An amputation of the hand is a devastating injury. It adversely affects the victim's ability to earn a livelihood, support a family, and carry out daily activities. It has a great psychological impact. We report a middle aged male with an amputation at the level of the distal forearm who underwent replantation. The operative details of this case are described. Awareness of the possibility of salvage should be spread among healthcare personnel and the need for immediate attention by a multispeciality team is advocated. This report reviews the literature related to the operative technique, contraindications and long term results.
Functional outcome of patients undergoing replantation of hand at wrist level-7 year experience
Indian Journal of Plastic Surgery, 2013
Background: Replantation is defined as reattachment of amputated limb using neurovascular and musculoskeletal structures in order to obtain recovery of limb. Re-vascularisation involves all the above steps in case of limb injuries that result in a near total amputation. Aim and Objective: To study the functional outcome of patients undergoing replantation of hand at wrist level. Material and Methods: This is a retrospective study of patients who underwent replantation of total amputation of hand at wrist level within a period of Jan 2003-June 2010. We evaluated post operative functional outcome compared to uninjured hand taking into consideration: 1. The patient′s overall satisfaction with the hand. 2. Recovery of flexor and extensor function of thumb and fingers. 3. Recovery of thumb opposition. 4. Recovery of sensations in the median and ulnar nerve distribution. 5. Ability of surviving hand to perform daily tasks. Results: There were total seventeen patients and age range was two...
Replantation of an Amputated Hand- A Landmark surgery with Multidisciplinary Team Approach
Cardiovascular Journal
An amputation of the hand is a disastrous traumatic injury especially for advanced machinery workers which adversely affects the victim’s ability to earn a livelihood, support a family, and carry out daily activities. It also produces great psychological impact. In the following case report, we described a middleaged male with an amputation at the level of the distal forearm who underwent replantation. The transfer of the amputated hand, operative technique and postoperative status are described. Awareness of the possibility of salvage should be spread among healthcare providers and the need for immediate attention by a multispecialty team is advocated. This report reviews the literature related to the operative technique, contraindications and long-term results. Cardiovasc j 2022; 15(1): 106-110
Archives of Orthopaedic and Trauma Surgery, 2009
For the past 45 years, the advent of microsurgery has led to replantation of almost every amputated part such as distal phalanx, finger tip, etc. Replantation of digits and hand can restore not only circulation, but also function and cosmetic of the amputated part. The goals of replantation are to restore circulation and regain sufficient function and sensation of the amputated part. Strict selection criteria are necessary to optimize the functional result. The management of this type of injuries includes meticulous preoperative management, microsurgical experience and continuous postoperative care. Among various factors influencing the outcome, the most important are the type and the level of injury, ischemia time, history of diabetes, age, sex, and smoking history. During the replantation procedure, bone stabilization, tendon repair, arterial anastomoses, venous anastomoses, nerve coaptation, and skin coverage should be performed. All structures should be repaired primarily, unless a large nerve gap or a flexor tendon avulsion injury is present. Adequate postoperative evaluation is mandatory to avoid early or late complications. To improve functional results, many replantation patients may need further reconstructive surgery.
Functional Salvage of a Hand After Unsuccessfull Attempt of Replantation
Clujul Medical, 2016
Amputation by crush injuries generally represents a contraindication for replantation, and especially when the lesion is caused by the summation of multiple concomitant traumatic mechanisms.We present the case of a 22 year- old female who arrived in our service with a crush/torsion amputation of all long fingers at the metacarpo-phalangeal level of the right hand. After the unsuccessful attempt of replantation, the functional reconstruction of the hand was achieved by using a double free flap transfer: anterolateral thigh perforator flap (ALT) and digital block transfer of second and third toes.
A Unique Case of Replantation of Previously Replanted Fingers
Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India, 2021
Replantation of digital amputations is now the accepted standard of care. However, rarely will a replantation surgeon be presented with amputated fingers which have been previously replanted. In our literature search, we could find only one publication where a replanted thumb suffered amputation and was successfully replanted again. We report the technical challenges and the outcome of replanting two fingers which suffered amputation 40 months after the initial replantation and were successfully replanted again. Replantation was critical since the amputated fingers were the only two complete fingers in that hand which had initially suffered a four-finger amputation. The second-time replantation of previously replanted fingers is reported to allay the concern of the reconstructive surgeon when faced with this unique situation of “repeat amputation of the replanted finger.” Second-time replantation is feasible and is associated with high-patient satisfaction. Replantation must be atte...
The Journal of Hand Surgery, 2013
A 39-year-old tetraplegic patient had paralysis of elbow, thumb, and finger extension and thumb and finger flexion. We transferred axillary nerve branches to the triceps long and upper medial head motor branches, supinator motor branches to the posterior interosseous nerve, and brachioradialis tendon to the flexor pollicis longus and flexor superficialis of the index finger. Surgery was performed bilaterally 18 months after spinal cord injury. At 12 months after surgery, we performed bilateral distal radioulnar arthrodesis percutaneously. By 22 months postoperatively, we observed triceps strength scoring M3 bilaterally and full metacarpophalangeal joint extension scoring M4 bilaterally. The thumb span was 53 and 66 mm from the proximal index phalanx on the right and left sides, respectively. Pinch strength measured 1.5 kg on the left side and 2.0 kg on the right. Before surgery, the patient was incapable of grasping; after surgery, a useful grasp had been restored bilaterally. (J Hand Surg 2013;xx:.