Hand Replantation

Replantation of a Completely Amputated Hand

J.M. is a 25-year-old right-handed gentleman who sustained a complete transverse amputation of his right hand at the mid-carpal level in July 2011 when his right hand became stuck in an industrial food mixer. JM underwent replantation of his right hand including a proximal row carpectomy followed by open reduction and internal fixation using three 0.62 Kirschner wires, repair of all of the flexor tendons, the median and ulnar nerves, the radial and ulnar arteries and venae comitantes to each artery as well as a dorsal vein, and the radial wrist extensor tendons (extensor carpi radialis longus and brevis). The other extensor tendons were avulsed at the musculotendinous junction obviating their primary repair. Subsequently, the patient underwent tendon transfers to restore thumb extension (palmaris longus to extensor pollicis longus) and finger extension (flexor carpi radialis to extensor digitorurm communis (x4), extensor indicis proprius and extensor digiti minimi quinti), repair of the flexor carpi ulnaris tendon, repair of the dorsal sensory nerves as well as repositioning of the wrist in more extension (20-25 degrees). At two-year follow-up, JM has an excellent aesthetic result and functional use of his right hand.

  • Date: November 14, 2013