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Replantation and functional reconstruction of mutilating injury of the palms

Cai Jinfang,Li Bingsheng,Cao Xuecheng,et al. Department of Orthopaedic Surgery,Jinan Militery Generel Hospital,Jinan 250031  
Objective To expand the indications of replantation of mutilated palms and improve the functional outcome. Methods 23 cases of mutilated palms were replanted from 1979 to 1996. Four types of replantation techniques were designed: (1) Two severed fingers were heterotopically replanted to the stump of the forearm; (2) Two or three fingers were heterotopically replanted to the wrist; (3) Five fingers were replanted to the stump of the forearm; (4) The index finger was replanted to the base of the first metacarpal, the second metacarpal was incised to form the first web and the other 3 fingers were replanted to the third, forth and fifth metacarpal. Results The reconstructed fingers survived in all the 23 cases. Five patients were followed up for over 1 year. Comprehensive evaluation of the hand function revealed a 32% failure rate. Conclusions Mutilated palms can be salvaged by heterotopic replantation and the functional result is good.
【CateGory Index】: R658.1
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