Indications and Surgical Techniques for Digit Replantation

Summary Finger amputations are devastating, life-changing inju-ries. They can occur from many different types of in-jury, but most often are caused by power tools or ma-chinery in the workplace. Modern microvascular surgicaltechniques have enabled surgeons to successfully reat-tach fingers that have been amputated at almost level ofinjury. Patient outcome and digit viability have improvedas surgeons have gained more experience with microvas-cular techniques, and have narrowed the operative indi-cations for replantation. Currently, replantation is rec-ommended for amputated thumbs, multiple digitamputations, and single digit amputations distal to theFDS insertion, as well as all amputations in children.Replantation surgery is technically demanding. Suc-cess relies on patient selection, meticulous operativetechnique, and postoperative monitoring. Most patientshave successful outcomes with at least protective sensa-tion and useful range of motion in the replanted digit.Though complications, including joint stiffness, tendonadhesions, malunion, and cold intolerance are not infre-quent, patient satisfaction following replantation is high.