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DOI: 10.1055/s-0040-1709951
Cross-Hand Replantation
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Abstract
Combined major injury to both upper extremities, in which one hand is amputated and structurally intact but not replantable, and the other hand is unsalvageable, is a rare setting in which cross-hand replantation may be considered. We report a case of an emergency cross-hand replantation performed at the wrist level. In our case, insertions of the wrist flexor and extensor tendons at the second and third metacarpal bases were retained at the recipient, allowing for early active wrist motion and finger motion by tenodesis. Fascicle-specific nerve coaptations were performed. The patient achieved satisfactory functional results, allowing him independence with daily living activities and return to gainful employment. At the time of telemedicine follow-up at 5 years, he was employed full-time, reported no difficulty or mild difficulty with most daily activities, and preferred the use of his replanted hand over a contralateral prosthesis.
Publication History
Article published online:
24 April 2020
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References
- 1 Malt RA, McDowell F. Cable from Cathay. N Engl J Med 1973; 288 (25) 1353-1354
- 2 Wang SH, Young KF, Wei JN. Replantation of severed limbs—clinical analysis of 91 cases. J Hand Surg Am 1981; 6 (04) 311-318
- 3 Kutz JE, Sinclair SW, Rao V, Carlier A. Cross-hand replantation: preliminary case report. J Microsurg 1982; 3 (04) 251-254
- 4 Adkins P, Graham B, Kutz JE. Functional evaluation of an emergency cross-hand replantation: a 9-year follow-up. J Hand Surg Am 1992; 17 (02) 214-216
- 5 Baumgartner R. Management of bilateral upper limb amputees. Orthop Clin North Am 1981; 12 (04) 971-976
- 6 Graham B, Adkins P, Tsai TM, Firrell J, Breidenbach WC. Major replantation versus revision amputation and prosthetic fitting in the upper extremity: a late functional outcomes study. J Hand Surg Am 1998; 23 (05) 783-791
- 7 Reagan DS, Reagan JM. Emergency cross-arm transfer. Plast Reconstr Surg 2000; 106 (03) 648-652
- 8 May Jr JW, Rothkopf DM, Savage RC, Atkinson R. Elective cross-hand transfer: a case report with a five-year follow-up. J Hand Surg Am 1989; 14 (01) 28-34
- 9 Zhang YL, Yang KF, Li C, Wei JN. Transmetacarpal replantation of the right hand onto the left. J Hand Surg [Br] 1991; 16 (04) 392-394
- 10 Cavadas PC, Ibañez J, Landin L. Elective cross-hand transfer with thumb transposition: case report. J Hand Surg Am 2008; 33 (10) 1813-1819