Replantation
WALANT Surgery for Flexor Tendon Injuries
September 14, 2020
The first microvascular procedures performed were the replantation of severed digits or even limbs following traumatic amputations.
The decision to attempt replantation is complex and individual to each patient. Factors affecting the patient as a whole, such as concomitant injuries or pre-existing medical conditions, and also the nature of the amputation, for example a ‘clean cut’ versus a tearing or stretching mechanism, must be taken into account. Ultimately the patient and treating staff must understand that even in the best circumstances a replanted limb may never be ‘normal’ and lengthy periods of rehabilitation and therapy are required.
Despite these challenges good outcomes can be achieved, as this example of a ring avulsion injury demonstrates.
The decision to attempt replantation is complex and individual to each patient. Factors affecting the patient as a whole, such as concomitant injuries or pre-existing medical conditions, and also the nature of the amputation, for example a ‘clean cut’ versus a tearing or stretching mechanism, must be taken into account. Ultimately the patient and treating staff must understand that even in the best circumstances a replanted limb may never be ‘normal’ and lengthy periods of rehabilitation and therapy are required.
Despite these challenges good outcomes can be achieved, as this example of a ring avulsion injury demonstrates.
In this case the bone, tendons, nerves, arteries and veins were all re-joined in one sitting. The patient reported being able to return to work a few months after the injury, and that after six months sensation in the replanted finger was almost normal. As this video demonstrates the range of movement in the digit and grip power are excellent.
I would like to thank this patient for agreeing to share their images.
I would like to thank this patient for agreeing to share their images.
