REPLANTATION SURGERY

From 1975 to 1988, replantation operations of fingers or hands were performed in 2,040 patients at the Division of Plastic and Reconstructive Surgery, Technical University Munich, Germany. The meticulous repair of blood vessels is still the most important step for a successful replantation. The liberal use of vein grafts very often makes replantations possible even in avulsion and crush injuries. The best functional results are achieved in replantations of distal finger parts, because an intact proximal interphalangeal joint and tendon apparatus guarantees almost a full range of motion. Age alone is not an exclusionary factor for replantation. Even 70 or 80 year old patients can achieve a satisfying functional result after replantation. Replantation as a matter of course is indicated in every amputation. Nevertheless, the extent of tissue damage, patient age and general health condition as well as the patient's wishes regarding a replantation have to be considered before performing a replantation. In addition, only continuous, long - term physical therapy by specialized physical therapists and the continuous postoperative attention of the surgeon ensure a satisfying result.