Background and objective.

Replantation rather than stump revision, is, with some exceptions, the best solution for amputations, specially in the upper limb.

In order to optimize results, self-evaluation is essential. Therefore, the objective of the current study is to collect and analyze the functional outcomes (including objective and subjective variables) of replantation surgeries performed at our Department of Plastic Surgery at the University Central Hospital of Asturias (Spain) in the last decade.

Methods.

We evaluate the outcomes of replatations performed at our department from 2010, using a similar system of a previous case series from 2000 to 2009. Thus, objective functional outcomes include articular range of motion, prehension strength and sensitive discrimination regarding to Mayo Modified Table score for distal to wrist amputations and Chen Criteria for proximal ones. Subjective results were evaluated according to Russell Questionnaire.

Results.

From January 2010, 37 attempts of upper limb replantation were performed, 6 of them in 2021 (excluded from global analysis). 83.87% were distal to wrist (most of them affecting the thumb) and 48.39% work accidents. Most of the lesions were caused by cutting machinery. Global survival of the replanted fragments was 75%, with partial necrosis and stiffness as main complications. Mean result was acceptable, with some good results (most of them thumbs). We had 2 proximal cases with good results. Satisfaction among patients was bigger than in amputated ones. All of them but 1 would recommend the surgery.

Conclusions.

Replantation is a complex procedure that, when properly indicated, is an optimal treatment of cripple lesions of the upper limb and preferred by our patients rather than an amputation. Our results, with a decreasing number of procedures, are acceptable, better in thumb lesions. Most of the patients use their hand to almost of all daily life activities, showing satisfaction with the results.

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