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Extremity Replantation pp 171–190Cite as

Secondary Procedures in Replantation

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Abstract

The goal of replantation surgery is to achieve a viable limb with the maximum function possible. In many instances, the functional outcome can be improved by secondary procedures. These secondary procedures require significant experience, and judgment, and show significant variability in their complexity and nature. There is no cookbook for these procedures, and actually little has been published on this topic. Treatment has to be tailored to every case individually based on the anatomy and the outcome of the replantation. In this chapter, we will describe general guidelines and lessons that we have learned in improving the outcome of replantation surgery through secondary revisions.

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References

  1. Sabapathy SR, et al. Replantation surgery. J Hand Surg Am. 2011;36(6):1104–10.

    Article  PubMed  Google Scholar 

  2. Matsuzaki H, Kouda H, Maniwa K. Secondary surgeries after digital replantations: a case series. Hand Surg. 2012;17(3):351–7.

    Article  PubMed  Google Scholar 

  3. Fufa D, et al. Digit replantation: experience of two U.S. academic level-I trauma centers. J Bone Joint Surg Am. 2013;95(23):2127–34.

    Article  PubMed  Google Scholar 

  4. Yaffe B, et al. Major upper extremity replantations. J Hand Microsurg. 2009;1(2):63–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Carlsen BT, Prigge P, Peterson J. Upper extremity limb loss: functional restoration from prosthesis and targeted reinnervation to transplantation. J Hand Ther. 2014;27(2):106–13.

    Article  PubMed  Google Scholar 

  6. Yu JC, et al. Secondary procedures following digital replantation and revascularisation. Br J Plast Surg. 2003;56(2):125–8.

    Article  PubMed  Google Scholar 

  7. Sabapathy SR, Bhardwaj P. Secondary procedures in replantation. Semin Plast Surg. 2013;27(4):198–204.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Griffin PA, Tan E, Katsaros J. Late arterial thrombosis in a replanted thumb: a case report. J Reconstr Microsurg. 1989;5(1):75–7.

    Article  CAS  PubMed  Google Scholar 

  9. Zhou M, et al. Vacuum assisted closure therapy for treatment of complex wounds in replanted extremities. Microsurgery. 2013. doi:10.1002/micr.22178. Epub ahead of print.

    PubMed  Google Scholar 

  10. Buncke HJ, Jackson RL, Buncke GM, Chan SWL. Surgical and rehabilitative aspects of replantation and revascularization of the hand. In: Scheider LH, Hunter JM, Mackin EJ, Callahan AD, editors. Rehabilitation of the hand: surgery and therapy. 4th ed. St. Louis: Mosby; 1995.

    Google Scholar 

  11. Haas F, et al. Immediate functional transfer of the latissimus dorsi myocutaneous island flap for reestablishment of elbow flexion in upper arm replantation: two clinical cases. J Trauma. 2004;57(6):1347–50.

    Article  PubMed  Google Scholar 

  12. Chaudhry S, Hopyan S. Bipolar latissimus transfer for restoration of elbow flexion. J Orthop. 2013;10(3):133–8.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Chuang DC, et al. Traction avulsion amputation of the major upper limb: a proposed new classification, guidelines for acute management, and strategies for secondary reconstruction. Plast Reconstr Surg. 2001;108(6):1624–38.

    Article  CAS  PubMed  Google Scholar 

  14. Sabapathy SR, Elliot D. Complex injuries to the flexor mechanism in the hand and the forearm. In: Cheema E, editor. Complex injuries of the hand. 1st ed. London: JP Medical Publishers, 2014;115–16.

    Google Scholar 

  15. Oberlin C, Béal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C56 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am. 1994;19:232–7.

    Article  CAS  PubMed  Google Scholar 

  16. Quaba AA, Elliot D, Sommerlad BC. Long term hand function without long finger extensors: a clinical study. J Hand Surg Br. 1988;13(1):66–71.

    Article  CAS  PubMed  Google Scholar 

  17. Scott FA, Howar JW, Boswick Jr JA. Recovery of function following replantation and revascularization of amputated hand parts. J Trauma. 1981;21(3):204–14.

    Article  CAS  PubMed  Google Scholar 

  18. Dec W. A meta-analysis of success rates for digit replantation. Tech Hand Up Extrem Surg. 2006;10(3):124–9.

    Article  PubMed  Google Scholar 

  19. Lin CH, et al. Hand and finger replantation after protracted ischemia (more than 24 hours). Ann Plast Surg. 2010;64(3):286–90.

    Article  CAS  PubMed  Google Scholar 

  20. Morrison WA, McCombe D. Digital replantation. Hand Clin. 2007;23(1):1–12.

    Article  PubMed  Google Scholar 

  21. Pomerance J, et al. Replantation and revascularization of the digits in a community microsurgical practice. J Reconstr Microsurg. 1997;13(3):163–70.

    Article  CAS  PubMed  Google Scholar 

  22. Sabapathy SR, et al. Technical considerations and functional outcome of 22 major replantations (the BSSH douglas lamb lecture, 2005). J Hand Surg Eur Vol. 2007;32(5):488–501.

    Article  PubMed  Google Scholar 

  23. Wang H. Secondary surgery after digit replantation: its incidence and sequence. Microsurgery. 2002;22(2):57–61.

    Article  PubMed  Google Scholar 

  24. Wang H, Oswald T, Lineweaver W. Secondary surgery following replantation. The mutilated hand. Philadelphia: Elsevier; 2005.

    Google Scholar 

  25. Schneider LH. Tenolysis and capsulectomy after hand fractures. Clin Orthop Relat Res. 1996;327:72–8.

    Article  PubMed  Google Scholar 

  26. Ross DC, et al. Tendon function after replantation: prognostic factors and strategies to enhance total active motion. Ann Plast Surg. 2003;51(2):141–6.

    Article  PubMed  Google Scholar 

  27. Dy CJ, et al. The epidemiology of reoperation after flexor tendon repair. J Hand Surg Am. 2012;37(5):919–24.

    Article  PubMed  Google Scholar 

  28. Jupiter JB, Pess GM, Bour CJ. Results of flexor tendon tenolysis after replantation in the hand. J Hand Surg Am. 1989;14(1):35–44.

    Article  CAS  PubMed  Google Scholar 

  29. Eggli S, et al. Tenolysis after combined digital injuries in zone II. Ann Plast Surg. 2005;55(3):266–71.

    Article  CAS  PubMed  Google Scholar 

  30. Whitaker JH, Strickland JW, Ellis RK. The role of flexor tenolysis in the palm and digits. J Hand Surg Am. 1977;2(6):462–70.

    Article  CAS  PubMed  Google Scholar 

  31. Lehfeldt M, Ray E, Sherman R. MOC-PS(SM) CME article: treatment of flexor tendon laceration. Plast Reconstr Surg. 2008;121(4 Suppl):1–12.

    Article  PubMed  Google Scholar 

  32. Sandvall BK, et al. Flexor tendon repair, rehabilitation, and reconstruction. Plast Reconstr Surg. 2013;132(6):1493–503.

    Article  CAS  PubMed  Google Scholar 

  33. Weinzweig N, Sharzer LA, Starker I. Replantation and revascularization at the transmetacarpal level: long-term functional results. J Hand Surg Am. 1996;21(5):877–83.

    Article  CAS  PubMed  Google Scholar 

  34. Friedrich JB, Katolik LI, Vedder NB. Soft tissue reconstruction of the hand. J Hand Surg Am. 2009;34(6):1148–55.

    Article  PubMed  Google Scholar 

  35. Muzaffar AR, Chao JJ, Friedrich JB. Posttraumatic thumb reconstruction. Plast Reconstr Surg. 2005;116(5):103e–22.

    Article  PubMed  Google Scholar 

  36. Paavilainen P, et al. Long-term results of transmetacarpal replantation. J Plast Reconstr Aesthet Surg. 2007;60(7):704–9.

    Article  PubMed  Google Scholar 

  37. Hanel DP, Chin SH. Wrist level and proximal-upper extremity replantation. Hand Clin. 2007;23(1):13–21.

    Article  PubMed  Google Scholar 

  38. Gelberman RH, et al. Digital sensibility following replantation. J Hand Surg Am. 1978;3(4):313–9.

    Article  CAS  PubMed  Google Scholar 

  39. Matev I. Thumb metacarpal lengthening. Tech Hand Up Extrem Surg. 2003;7(4):157–63.

    Article  PubMed  Google Scholar 

  40. Kempton SJ, McCarthy JE, Afifi AM. A systematic review of distraction osteogenesis in hand surgery: what are the benefits, complication rates, and duration of treatment? Plast Reconstr Surg. 2014;133(5):1120–30.

    Article  CAS  PubMed  Google Scholar 

  41. Mirzoyan AE. Reimplantation and lengthening with use of the Ilizarov apparatus after a traumatic amputation of the leg. A case report. J Bone Joint Surg Am. 1996;78(3):437–8.

    CAS  PubMed  Google Scholar 

  42. Unal MB, Cansu E, Parmaksizoglu F. Lengthening of a thumb distal phalanx replanted to its metacarpus because of loss of the proximal phalanx: case report. J Hand Surg Am. 2011;36(4):661–4.

    Article  PubMed  Google Scholar 

  43. Matev IB. Thumb reconstruction after amputation at the interphalangeal joint by gradual lengthening of the proximal phalanx. A case report. Hand. 1979;11(3):302–5.

    Article  CAS  PubMed  Google Scholar 

  44. Vucetic CS. Forearm elongation after hand replantation. A case report. J Bone Joint Surg Am. 2005;87(1):181–6.

    Article  PubMed  Google Scholar 

  45. Nisanci M, et al. Replantation of a crush amputation of distal tibia followed by lengthening with Ilizarov circular external fixator: two-year follow-up. Microsurgery. 2002;22(7):295–9.

    Article  PubMed  Google Scholar 

  46. Betz AM, et al. Primary shortening with secondary limb lengthening in severe injuries of the lower leg: a six year experience. Microsurgery. 1993;14(7):446–53.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Hand and Reconstructive Microsurgery, and Burns, Ganga Hospital, Coimbatore, India

    S. Raja Sabapathy MD, MCh, DNB, FRCS, MAMS

  2. Division of Plastic Surgery, University of Wisconsin Hospital and Clinics, Madison, WI, USA

    Jenny Tzujane Chen MD & Ahmed M. Afifi MD

Authors
  1. S. Raja Sabapathy MD, MCh, DNB, FRCS, MAMS
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  2. Jenny Tzujane Chen MD
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  3. Ahmed M. Afifi MD
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Corresponding author

Correspondence to S. Raja Sabapathy MD, MCh, DNB, FRCS, MAMS .

Editor information

Editors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    A. Neil Salyapongse

  2. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    Samuel O. Poore

  3. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    Ahmed M. Afifi

  4. Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin, USA

    Michael L. Bentz

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Sabapathy, S.R., Chen, J.T., Afifi, A.M. (2015). Secondary Procedures in Replantation. In: Salyapongse, A., Poore, S., Afifi, A., Bentz, M. (eds) Extremity Replantation. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7516-4_14

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  • DOI: https://doi.org/10.1007/978-1-4899-7516-4_14

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7515-7

  • Online ISBN: 978-1-4899-7516-4

  • eBook Packages: MedicineMedicine (R0)

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