Most of us have read news stories or headlines about replantation, or may even know someone who has had this procedure done. What is it? In the world of hand surgery, it is the surgical reattachment of a finger, hand, or even an arm after it has been severed from the body.
Unfortunately, replantation is often an emergency surgery and this can make the decision-making process around it a bit complicated. Generally, a limb or digit can be reattached if:
- It will work better than a prosthetic, or just as well.
- It is in good enough condition to safely attach.
- The patient feels that the lengthy recovery and rehabilitative process warrants the procedure.
It may seem obvious that a somewhat functional hand or arm is better than none at all, but there are many instances when a prosthetic will actually work far better and not cause the individual any further pain or discomfort. These are all things that must be taken into consideration before replantation surgery is done.
Of course, when it is the arms or hands in question, the need for these limbs is extreme, and so it can be very challenging to make the right decisions. This is why an experienced and knowledgeable surgeon must be consulted if possible.
How is it Done?
There are many things that have to be done before the procedure can be accomplished. First and foremost is an examination of the finger, hand, or arm that has been severed from the body. The damaged tissue has to be taken away; bone must be assessed and even trimmed if needed. All of the nerves, tendons, muscles, veins, and arteries have to be reconnected and new tissue may need to be grafted over the areas where it was lost or destroyed. (AAOS.org, 2015)
There are no guarantees to replantation success, and it is a very long period of recovery. However, it should be noted that the further down along the arm the replantation occurred, the more likely it is to be restored to its former use and condition. Additionally, joint injuries are less likely to heal quickly than non-joint injuries. And no replanted digit or organ can ever be “100%” due to the likely nerve and tissue damage.
It is up to the patient to do the hard work of recovery and use therapy and rehabilitation to get the best results. The first phases of recovery involve nerve healing and tissue growth. Once this has stabilized, the use of physical or occupational therapy can ensure that the limb is slowly and carefully restored to the fullest use possible.
There are also some complications that can arise, including emotional struggles with the loss of the limb if the replantation process does not succeed. Working with a qualified surgical team is the only way appropriate path. They can help a patient and their family through every part of the process and will explore every option for the fullest recovery possible.
AAOS.org. Replantation. 2015. http://orthoinfo.aaos.org/topic.cfm?topic=A00314