[Status of replantation--indications and limits in hand surgery]

Abstract

Replantation of severed fingers or hand segments has become a routine procedure. Up to now the following clinical conditions are accepted as clear indications: 1. Amputation at the wrist or metacarpal level. 2. Amputation of several fingers. 3. Thumb amputation. 4. Amputation in childhood. 5. Special hand functions. Our clinical results in 1123 patients suffering from 973 total and 899 subtotal amputations are presented. Due to frequent employment of micro-venous interposition grafts success rates of about 80% could be obtained even in cases of crush or avulsion injuries. Recommendations concerning the improvement of the operational conditions and functional rehabilitation are discussed.