Upper Extremity Replantation

John S. Taras

The advent of microsurgical techniques to extremity trauma has enhanced the surgeon's ability to reconstruct amputating injuries by replantation. As more surgeons are now trained in microsurgical techniques, replantation is routinely offered at many trauma centers. Viability rates higher than 80% have been reported in several published series.1-15 Replantation is defined as the reattachment of an extremity part that has been completely cut off and reconnection of the damaged vascular structures. Revascularization is the repair of a partially amputated extremity part with impaired circulation.

As we gain technical experience in restoring extremity function through replantation, we gain a better understanding of the factors influencing the decision to replant or revascularize an amputated part. Reasonable expectations should compel the decision to replant or revascularize an injured extremity or to amputate and fit a prosthetic. Every case must be analyzed individually, taking into consideration the circumstances of the trauma and the patient's needs and desires.16-18

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