Replantation of digits is the surgical repair of completely amputated fingers or toes. With an incomplete amputation part of the digit remains attached to the body by skin, artery, vein, or nerve. A process called revascularization is used to reattach the rest of the digit.

While the patient is sedated, using regional or general anesthesia, the bone ends may be shortened to remove tension on the repaired blood vessels. The digit is put in place and the bone is stabilized with wires or a plate and screws. Tendon repairs are done next.

The nerves and vessels are then repaired with special surgical instruments. This part of the surgery is most critical to its success. The skin is then closed. A bulky dressing is applied.

Young children may need to wear a cast to protect the area from injury.

The surgery is recommended in a case of amputated fingers or toes, when the fingers or toes are in a condition that would allow replantation.

Risks for any anesthesia include the following:

• Reactions to medications
• Problems breathing

• Bleeding
• Infection

• Death of the replanted tissue
• Reduced nerve or movement function in the replanted digit

Children are especially good candidates for replantation surgery because of their great ability to heal and regenerate tissue. Replantation of an amputated part is ideally performed within 4 to 6 hours after injury. However, success has been reported up to 24 hours after the injury if the amputated part has been cooled.

Proper care of the amputated part or parts is critical to successful replantation. Under the right conditions, the long-term prognosis for the restoration of use in the digit is quite good.

Special care is needed in the hospital to monitor and maintain the blood flow to the replanted part. The arm or leg will be kept raised. The room may be kept quite warm to ensure that blood flow to the skin is not changed due to cooling.

After discharge from the hospital in about a week, the patient may need to wear a cast to protect the part. Continuing blood flow checks are necessary.