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Generally, severe medical illnesses, including chronic immunosuppression and heavy steroid use, have been deemed relative contraindications for replantation surgery. We report the successful replantation of an amputated thumb in a patient who had previously undergone heart transplantation and was on therapeutic immunosuppression. Despite extensive soft-tissue damage and joint involvement, thumb function and sensibility returned to acceptable levels. This case demonstrates that digital bony union, tendon repair healing, and nerve regeneration are not significantly altered by the standard immunosuppressive regimen following major organ transplant. The implications raised by this case for possible transplantation of allograft digits or limbs are discussed in detail.
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http://dx.doi.org/10.1097/00006534-199109000-00022 | DOI Listing |
World J Clin Cases
February 2025
Department of Orthopaedics, Clinique Trenel, Sainte-Colombe 69560, France.
Background: Thumb replantation following complete traumatic avulsion requires complex techniques to restore function, especially in cases of avulsion at the level of the metacarpophalangeal joint (MCP I) and avulsion of the flexor pollicis longus (FPL) at the musculotendinous junction. Possible treatments include direct tendon suture or tendon transfer, most commonly from the ring finger. To optimize function and avoid donor finger complications, we performed thumb replantation with flexion restoration using brachioradialis (BR) tendon transfer with palmaris longus (PL) tendon graft.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
BG Klinikum Unfallkrankenhaus Berlin, Department of Hand-, Replantation- and Microsurgery and Chair of Hand-, Replantation- and Microsurgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
Introduction: Rhizarthrosis, or osteoarthritis of the trapeziometacarpal joint, predominantly affects women over 50, with up to 30% experiencing some degree of arthritis in this joint. Traditional surgical approaches, such as trapeziectomy with ligament reconstruction, can result in some patients in persistent pain or limited functionality. TMC ball-in-socket arthroplasty, with a cup placed in the distal scaphoid, offers a promising alternative to traditional arthrodesis or resection-suspension arthroplasty.
View Article and Find Full Text PDFFront Surg
December 2024
Senior Department of Orthopedics, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
One of the primary challenges in hand microsurgical reconstruction lies in addressing severe hand injuries, particularly those involving multiple finger amputations, as autologous replantation might not fully restore hand functionality. In such scenarios, fully shaped reconstruction of a severed finger combined with Ectopic banking could yield superior reconstructive outcomes and enhance the amputated limb's function. This case report presents a unique approach that combines ectopic replantation of an amputated finger with interphalangeal reconstruction methods to restore both the form and function of the hand.
View Article and Find Full Text PDFFront Bioeng Biotechnol
November 2024
Department of Orthopedics, Department of Hand Surgery, Qilu Hospital of Shandong University, Jinan, China.
Objectives: This work aimed to study the long-term outcome and function of a heterotopic replanted finger.
Methods: Retrospective analysis of two cases of successful finger reconstruction after finger heterotopic replantation. One case was a severed thumb, and the other case was a severed finger.
Background: Following upper limb amputation, surgeries such as arm transplantation or replantation might be an option to restore function. After such surgeries, rehabilitation of the arm is needed. However, conventional rehabilitation is dependent on some volitional movement of the arm.
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