What is Replantation?

Replantation is a procedure during which a surgeon will reattach a finger, hand or arm that has been completely cut from a person’s body. Replantation, however, isn’t always an option. A surgeon will only perform this procedure if the limb is still expected to function without pain. Sometimes, the body part is too damaged to perform a replant.

This procedure takes a number of hours to complete. The steps include:

• Step 1: Damaged tissue is carefully removed.
• Step 2: Bone ends are shortened and rejoined with pins, wires, or plates and screws. This holds the part in place to allow the rest of the tissues to be restored.
• Step 3: Muscles, tendons, arteries, nerves and veins are then repaired. Sometimes grafts or artificial spacers of bone, skin, tendons and blood vessels may be needed, too. The grafts can be from your own body or from a tissue bank.

The recovery after this procedure can be long. Even after surgery, it takes time for the nerves to grow back. Nerves grow about an inch per month, which means it can take months before the feeling in your fingertips returns. However, it’s important to note that the replanted body part will never function exactly as it did before. Most doctors consider 60% to 80% of its original use an excellent result.

Other recovery factors can include:

• Age. Younger patients have a better chance of their nerves growing back. They may regain more feeling and movement in the replanted part.
• Area of injury. Generally, more use will return to the replanted part if it is further down the arm.
• Joint vs. non-joint injury. More movement will return for patients who have not injured a joint.
• Severed vs. crushed body part. A cleanly severed part usually regains better function after replantation than one that has been pulled off or crushed.

Physical therapy and temporary bracing are important to the recovery process. Braces help protect the newly repaired tendons and allow you to move the replanted body part. Therapy helps keep joints from getting stiff, helps keep muscles mobile, and helps keep scar tissue to a minimum. Replantation can also affect you emotionally. You may feel shock, grief, anger, disbelief or disappointment because the body part is not as it was before. These feelings are common. Talking about these feelings with your doctor often helps you come to terms with the outcome. Your doctor may also ask a counselor to assist with this process.

Learn more about replantation and other hand surgeries at www.HandCare.org.