Replantation Outcomes

Abstract

Replantation aims to restore the amputated part to its anatomical site, preserving function and appearance. Outcome depends on factors intrinsic to the patient and to the nature of the injury. Young patients who have distal, cleanly amputated extremities have the best return of function; multiple levels of injury, crush, or avulsing injuries have less. Patients must be fully informed about the commitment to rehabilitation and the possibility of multiple surgeries needed for best results. Similarly, patient and surgeon expectations should be evaluated and addressed before replantation. Meticulous microsurgical technique, comprehensive occupational therapy, and perseverance are needed for success. Addressing these issues promotes a team rehabilitation to restore function while getting the amputation patient back to productive position in society.

Predictors of Hand Dexterity after Single-Digit Replantation

“…Single-digit amputation through Tamai's zone 3 to 4 may be relatively contraindicated for replantation surgery because satisfactory functional recovery is difficult to achieve due to poor finger motion after replantation at this level. [13][14][15][16][17] Although some investigators have recommended revision amputation at this level, 9 we consider that decreased finger motion does not always affect finger dexterity based on the current results. Thus, replantation surgery may be relatively indicated in patients who have undergone single-digit Tamai's zone 3 to 4 amputation except in patients with severe avulsion injuries.…”

Management of traumatic amputations of the upper limb

“…29 Functional outcomes depend on the level of amputation, and in general, the more distal the amputation, the better the functional result of replantation. 30 Several studies have shown that replants achieve a mean of 50% total active motion and 50% grip strength. 31 32 Recovery of sensibility is dependent on the level of injury, need for nerve grafts, and the patient's age.…”

Immediate Revascularisation of Borderline Ischemic Limbs Followed by Replantation

“…1 With advances in microsurgery and infrastructure in recent years and increased experience of surgeon the success of salvage of amputated limbs via replantation and revascularization was 80-90%. [2][3][4][5] To get better survival and improved function replantation within ischemia time is helpful. But in our country due to multiple factors like limited centres, distance to cover, road conditions, poor awareness, and many patients reach hospitals after 6-8hrs of warm ischemia.…”