Midpalm hand replantation done successfully.

On Friday the 28th August 2009, a tin sheet cutting blade severed the dominant right hand of a worker. Accident time was 10.00AM. The amputated part was very correctly preserved by ‘bag in bag’ method by the local Consultant. He reached Sparsh at 3.30PM. Dissection of the amputated part, basic workup, anaesthesia was started at 4.00PM. Bony Synthesis achieved using 5 K wires, one for each finger. Flexor tendons were repaired. Microanastomosis of 2 arteries started blood flow in the severed part, 10 hours after separation. Extensor tendons were repaired and 3 dorsal veins anastomosed under the Operating Microscope. Good perfusion started and loose skin closure followed by plaster immobilisation done. The whole procedure took 9 hours for completion. On day 5, all fingers including the thumb are doing well. This is a difficult level for replantation, good planning, an able team and favorable factors yielded a gratifying result.

This August, it is 2 years since the accident. The patient has started moving the fingers and has regained sensations enough to make for him to use those fingers. He has joined back in the same factory, in the same position that he was in before the injury. This is the final parameter of the usefulness of replantation.

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