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Case Reports
. 2023 May 2;56(3):273-275.
doi: 10.1055/s-0043-1768916. eCollection 2023 Jun.

Replantation of an Amputated Hand at Wrist Level Due to Self-Mutilation: Considerations in Management

Ashwini Vardharajan  1 , Monusha Mohan  2 , Dakshana Pushpanathan  3 , Hari Venkatramani  2 , S Raja Sabapathy  2
Affiliations
Case Reports

Replantation of an Amputated Hand at Wrist Level Due to Self-Mutilation: Considerations in Management

Ashwini Vardharajan et al. Indian J Plast Surg. .

Abstract

Major self-mutilations include injury to limbs, eyes, or genitals due to various psychiatric illnesses. Limb amputations are grievous injuries that radically decrease the quality of life. Controversy exists as to the advisability of replantation of the self-amputated limb. We report a case of self-amputation of the hand in a 54-year-old gentleman in a fit of psychosis. He underwent replantation of the hand and was given timely psychiatric help. Interdisciplinary management helped in improving the mood of the patient and he cooperated well with the rehabilitation schedule. Recent literature encourages surgeons to replant the limb and treat the mental illness with close observation for warning signs. We conclude that replantation along with early initiation of psychiatry treatment can help the patient overcome psychosis, realize the implications of his actions, and provide the motivation to perform physiotherapy to achieve the optimum outcome possible in the replanted hand.

Keywords: major self-mutilation; psychiatry; replantation.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Clinical picture of the amputated left hand at the wrist level with the radiograph at presentation.
Fig. 2
Fig. 2
Replanted left hand showing range of flexion and extension of fingers at 4 months followup.
See this image and copyright information in PMC

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References

    1. Davies S J, Doyle M P. Major self-mutilation leading to complete amputation of the hand during an acute psychotic episode. Case Stud Surg. 2016;2(03):6–9.
    1. Large M, Babidge N, Andrews D, Storey P, Nielssen O. Major self-mutilation in the first episode of psychosis. Schizophr Bull. 2009;35(05):1012–1021. - PMC - PubMed
    1. Stewart D E, Lowrey M R. Replantations surgery following self-inflicted amputation. Can J Psychiatry. 1980;25(02):143–150. - PubMed
    1. Sabapathy S R, Venkateswaran G, Boopathi V, Subramanian J B. “On Arrival Block”-management of upper extremity trauma with resuscitation in the operating room. Plast Reconstr Surg Glob Open. 2020;8(10):e3191. - PMC - PubMed
    1. Crawford A, Wand A PF, Smith M A. Self-amputation of the hand: issues in diagnosis and general hospital management. Australas Psychiatry. 2016;24(02):173–175. - PubMed

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