Replantation of digits

Replantation of digits is surgery to reattach fingers or toes that have been cut off (amputated).

Description

Surgery is done the following way:

• General anesthesia  will be given. This means the person will be asleep and unable to feel pain. Or regional anesthesia ( spinal and epidural ) will be given to numb the arm or leg.

  General anesthesia

  General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive the...

   

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  Spinal and epidural

  Spinal and epidural anesthesia are medicines that numb parts of your body to block pain. They are given through shots in or around the spine....

   

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• The surgeon removes damaged tissue.
• The ends of the bones are trimmed. 
• The surgeon places the finger or toe (called the digit) in place. The bones are rejoined with wires or a plate and screws.
• Tendons are repaired, followed by nerves and blood vessels. Nerve and blood vessel repair is the most important step to the success of the procedure. If needed, tissue with nerves and blood vessels from another part of the body is used.
• The wound is closed with stitches and bandaged.

Why the Procedure Is Performed

The surgery is done when fingers or toes have been amputated, and are in a condition that would allow replantation.

Risks

Risks for anesthesia and surgery in general include:

• Reactions to medicines, breathing problems
• Bleeding, blood clots, infection

Risks of this surgery include:

• Death of the replanted tissue
• Decreased nerve function or movement in the replanted digit
• Stiffness of the digits
• Pain that continues after surgery 

After the Procedure

Special care will be taken while you are in the hospital to make sure blood flows properly to the reattached part. The arm or leg will be kept raised. The room may be kept warm to ensure proper blood flow. The reattached part will be checked often to make sure there is good blood flow.

After you are released from the hospital, you may need to wear a cast to protect the finger or toe. The surgeon may prescribe blood-thinning medicines to prevent blood clots.

Proper care of the amputated part or parts is very important to successful replantation. Under the right conditions, there is a good chance that the surgery can restore the use of the finger or toe. You will need follow-up visits with your health care provider, who will continue checking blood flow in the surgery area.

Outlook (Prognosis)

Children are better candidates for replantation surgery because of their greater ability to heal and regrow tissue.

Replantation of an amputated part is best done within 6 hours after the injury. But replantation can still be successful if the amputated part has been cooled for up to 24 hours after the injury.

You will not have the same flexibility in the finger or toe after surgery. Pain and sensation changes may continue.