This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by SABAPATHY, S. R. Articles by RAJASEKARAN, S. Search for Related Content PubMed Articles by SABAPATHY, S. R. Articles by RAJASEKARAN, S. Social Bookmarking                         What's this?

Technical Considerations and Functional Outcome of 22 Major Replantations (The BSSH Douglas Lamb Lecture, 2005)

From the Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, Tamil Nadu 641 043, India

Correspondence: Dr S. Raja Sabapathy, MS, MCh, DNB, FRCS, Head of Department, Department of Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, Tamil Nadu, 641 043, India. Tel.: +91 422 2485000; fax: +91 422 2436444. E-mail:rajahand{at}vsnl.com

Twenty-two consecutive major replantations carried out over a 5-year period were assessed with a minimum follow-up of 2 years. Only two patients suffered guillotine amputations. The remainders were either crush, or crush avulsion amputation. Replantation was successful in 20 cases. When analysed by Chen’s criteria, there were three Grade I, nine Grade II, six Grade III and two Grade IV results. Most patients with successful replants put the hand to greater use with time and replantation greatly added to the overall well-being of the patient. We consider major replantation as a worthwhile procedure. Radical debridement, bone shortening and well laid out protocols to reduce the ischaemia time are important for success. The technical details which we believe to be important for success are outlined. With decreasing numbers of such injuries in most countries, this paper may help surgeons faced with an occasional patient with a major amputation to make the right decisions.

Key Words: major replantation • techniques • functional outcome

Journal of Hand Surgery (European Volume), Vol. 32, No. 5, 488-501 (2007)
DOI: 10.1016/J.JHSE.2007.06.013


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?