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During a period of 4 years, we attempted replantation of an amputated thumb in 21 patients. We present the survival rate as well as the functional recovery in correlation with type of injury. In 21 thumbs, 16 survived surgery (76.2%); 2 out of 5 losses belonged to the guillotine category and 3 belonged to the crush-avulsion category. Out of the 11 thumbs that belonged to the crush-avulsion type, 8 survived, which is a 72.7% success rate. Eight out of 10 thumbs of the guillotine type survived, an 80% success rate. The cosmetic and functional result was satisfactory.

During the past four years, we have attempted to replant and revascularize 57 hands and fingers in 43 patients. The total success rate was 81%. Replantation of hands severed cleanly (guillotine type) and those with slight local crush injuries had the highest success rate. As for hand function, amputations at zones III and IV with end-to-end suturing of the tendons and nerves presented the highest degree of function when evaluated objectively and subjectively. All patients presented a high degree of satisfaction with the outcome of the operation.

Eighty-three patients, with 96 instances of radial or ulnar arterial damage, were treated over a four-year period using microsurgical techniques. Thirty-one patients, with 43 arterial repairs, were available for evaluation. In the 14 patients with a single arterial repair, 4 resulted in thrombosis (71.5% success rate). When both arteries required repair, our success rate was 75.9%, with 7 thromboses. The overall success rate was 74.5%. We attribute the high patency rate to strict microsurgical technique, the repair of the vessels in the early stages after trauma, and the use of vein grafts after complete resection of the damaged portion of the vessel.