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The focus of replantation of any part of the upper extremity is maximizing functional outcomes rather than simply surviving the amputated part. Functional outcomes depend on the anatomical characteristics of the injury and patient-specific factors. Anatomical considerations include the level of amputation and the degree of injury to the arterial intima and other soft tissue structures. Other considerations must be given to patient factors such as age, occupation, and cultural significance attributed to the hands. This activity reviews the technique, indications, contraindications, and complications of digit replantation and highlights the interprofessional team's role in managing patients with digital amputations. Objectives: Identify the indications for digital replantation. Determine the complications of digit replantation. Evaluate the contraindications of digit replantation. Communicate the importance of improving care coordination among the interprofessional team to enhance the delivery of care for patients undergoing digit replantation. Access free multiple choice questions on this topic.

The focus of replanting any part of the upper extremity is maximizing functional outcomes rather than the simple survival of the amputated part. Functional outcomes depend on the anatomical characteristics of the injury and patient-specific factors. Anatomical considerations include the level of amputation and the degree of injury to the arterial intima and other soft tissue structures. Other considerations must focus on patient factors such as age, occupation, and cultural significance attributed to the hands.[1][2][3][4]

Complications of flexor tendon injuries can include bleeding, infection, replant failure, and finger stiffness. Venous congestion of the finger is a common problem as anastomosis of damaged dorsal veins is often difficult. Various strategies to prevent or treat venous congestion exist, including removing the nail plate, fishmouth incisions over the fingertip with heparin pledget application, or the application of leeches. Any patient begun on leech therapy should also be placed on ciprofloxacin therapy to prevent infection from Aeromonas hydrophilia.

Digit reimplantation requires an interprofessional team. Once the digit is reimplanted, close monitoring is required to ensure that no ischemia or infection occurs. Following the surgery, patients require prolonged physical therapy to regain joint function and strength. While digit reimplantation does have success, the procedure does not work for everyone.[11][12][13]