This 19-year-old machinist sustained bilateral transmetacarpal amputations following a punch press injury. He suffered crush amputations of all eight fingers through the metacarpophalangeal joints, sparing both thumbs. Replantation was performed. Primary tenorrhaphy and nerve repair could not be performed owing to the extensive zone of injury. Two fingers could not be salvaged. Secondary procedures included tendon and nerve grafting, metacarpophalangeal joint capsulectomies and resection arthroplasties with silastic joints, and tenolyses.
Here is the patient at two-year follow-up.