Hand replantations following complete amputations at the wrist joint: First experiences in Hanoi, Vietnam

Five completely amputated hands at the level of the wrist joint were replanted. The five patients were all men, ranging from 19 to 31 years and the amputations were all the result of knife injuries. All the revascularizations were successful. Secondary tenolysis was required in one case. Postoperative functional results compared to the uninjured hand were evaluated according to five main criteria: (1) the patient's overall satisfaction with the hand; (2) recovery of flexor and extensor function of the thumb and fingers; (3) recovery of thumb opposition; (4) recovery of sensitivity in the median and ulnar nerve distributions; (5) ability of the surviving hand to perform daily tasks. The results showed that, although the replanted hands were never functionally as good as the contralateral hand, the patients were able to use them satisfactorily for activities of daily living. Our results demonstrate that replantation following complete amputation at the wrist joint level as a result of a sharp injury is extremely worthwhile and has excellent potential for functional recovery.