Heterotopic Transarticular Replantation: A Functional Reconstruction Design for a Mutilated Hand with Multiple Digit Involvement

Case:A patient sustained a high-energy trauma that resulted in amputation of the middle and ring fingers, along with injuries to the thumb and the index finger. The amputations were not clean; therefore, heterotopic replantation of the best amputated part of the finger to the most functional stump was undertaken. Transarticular replantation was done at the level of the proximal interphalangeal joint without osseous fixation. Early active motion was initiated the next day. The replanted finger had excellent function. Conclusion:Whenever possible, designing a heterotopic transarticular replantation can minimize the functional drawbacks resulting from the prolonged immobilization often associated with fracture fixation.