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CC BY-NC-ND 4.0 · Indian J Plast Surg 2020; 53(01): 124-130
DOI: 10.1055/s-0040-1709951
Case Report

Cross-Hand Replantation

S. Raja Sabapathy
1   Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
,
Hari Venkatramani
1   Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
,
Sanjai Ramkumar
1   Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
,
Monusha Mohan
1   Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India
,
Dafang Zhang
2   Department of Orthopaedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States
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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.

Keywords

cross-hand replantation - replantation - mangling injury


Publication History

Article published online:
24 April 2020

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