Replantation is the surgical reattachment of a finger, hand or arm that has been completely severed from a person’s body. This involves bone, tendons, nerves, arteries and veins. Often, this is not possible when the amputated part is too badly damaged. Blood flow must be re-established through the arteries and veins in order for the amputated part to survive. Even if the amputated part survives, it doesn’t matter unless useful function is restored. Restoration of function depends upon the severity of injury as well as the combined efforts of the surgeon, therapist and patient. The best efforts and intentions of the patient and occupational therapist can be thwarted by poor compliance on the part of the patient. In the case of an unsuccessful replantation, completion amputation with or without a prosthesis may be an option. A prosthesis can look almost identical to the amputated part, provide excellent function and, often, both.
There are a number of steps to performing a replantation. These must be performed in an orderly and precise fashion. First, meticulous debridement of non-viable tissue must be done. The bones are then rejoined with either pins or plate and screws, occasionally with shortening of the bone ends. Next, the tendons and muscles are repaired. Lastly, under the microscope, the nerves, arteries and veins are repaired. Occasionally, vein grafts are needed to bridge any gap in anastomosis of the arteries and veins.
Dr. Norman Weinzweig, Director of The Chicago Institute for Hand Surgery & Rehabilitation, has extensive clinical experience in dealing with the most complex hand injuries including replantations of thumbs, fingers, hands and arms with excellent functional outcomes. Dr. Norman Weinzweig is one of the most experienced hand microsurgeons in the country having replanted or revascularized hundreds of amputated thumbs, fingers, hands, or arms over the past 25 years with outstanding clinical outcomes.
