Transmetacarpal replantation
Introduction. Transmetacarpal amputation (TA) distal to the superficial palmar arch is one of the most difficult procedures in replantation surgery because it requires the reconstruction of blood vessels, muscles, tendons, bones, nerves, and s kin. We present a case of a patient with TA of the left...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2024-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502400044E.pdf |
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| author | Erić Dražan Kovačević Maksim Dostić Milivoje Đorđević-Marić Sanja Kojić Siniša Kapor Slobodan Ninković Milomir |
| author_facet | Erić Dražan Kovačević Maksim Dostić Milivoje Đorđević-Marić Sanja Kojić Siniša Kapor Slobodan Ninković Milomir |
| author_sort | Erić Dražan |
| collection | DOAJ |
| description | Introduction. Transmetacarpal amputation (TA) distal to the superficial palmar arch is one of the most difficult procedures in replantation surgery because it requires the reconstruction of blood vessels, muscles, tendons, bones, nerves, and s kin. We present a case of a patient with TA of the left hand and micro-surgical replantation. Case report. A 23-year-old left-hand dominant male worker with a positive smoking history sustained TA from a radial saw blade and avulsion injury of the palmar side of the thumb with no other apparent injuries. The time between the amputation and replantation was 4 hrs. The patient sustained the amputation at the level of metacarpophalangeal joints. The successful replantation included: wound and intrinsic muscles debridement, microvascular anastomoses of the blood vessels, internal fixation of the metacarpal bones, neurorrhaphy, tenorrhaphy, and wound closure with local skin flap for thumb soft tissue defect. The patient was followed for seven years postoperatively. Conclusion. The replantation surgery requires a specialized department and well-educated teams of hand microsurgeons, orthopedic surgeons, and anesthesiologists. The most important factors that influenced the outcome after the replantation in the presented case included the type and level of injury, ischemia time, comorbidities, age, smoking history, and physical therapy. |
| format | Article |
| id | doaj-art-cb9e9a5cfb7d4fcd9d051f7edc908ffb |
| institution | OA Journals |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-cb9e9a5cfb7d4fcd9d051f7edc908ffb2025-08-20T02:02:09ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202024-01-0181959259610.2298/VSP240112044E0042-84502400044ETransmetacarpal replantationErić Dražan0Kovačević Maksim1Dostić Milivoje2Đorđević-Marić Sanja3Kojić Siniša4Kapor Slobodan5Ninković Milomir6Al Emadi Hospital, Department of Plastic and Reconstructive Surgery, Doha, QatarUniversity of East Sarajevo, Faculty of Medicine, Foča, Bosnia and HerzegovinaUniversity of East Sarajevo, Faculty of Medicine, Foča, Bosnia and HerzegovinaUniversity of East Sarajevo, Faculty of Medicine, Foča, Bosnia and HerzegovinaSpecial Hospital for Plastic, Reconstructive, and Aesthetic Surgery – Varis Clinic, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, Institute of Anatomy “Niko Miljanić”, Belgrade, SerbiaInternational Medical Center Priora, Department of Plastic and Reconstructive Surgery, Čepin, CroatiaIntroduction. Transmetacarpal amputation (TA) distal to the superficial palmar arch is one of the most difficult procedures in replantation surgery because it requires the reconstruction of blood vessels, muscles, tendons, bones, nerves, and s kin. We present a case of a patient with TA of the left hand and micro-surgical replantation. Case report. A 23-year-old left-hand dominant male worker with a positive smoking history sustained TA from a radial saw blade and avulsion injury of the palmar side of the thumb with no other apparent injuries. The time between the amputation and replantation was 4 hrs. The patient sustained the amputation at the level of metacarpophalangeal joints. The successful replantation included: wound and intrinsic muscles debridement, microvascular anastomoses of the blood vessels, internal fixation of the metacarpal bones, neurorrhaphy, tenorrhaphy, and wound closure with local skin flap for thumb soft tissue defect. The patient was followed for seven years postoperatively. Conclusion. The replantation surgery requires a specialized department and well-educated teams of hand microsurgeons, orthopedic surgeons, and anesthesiologists. The most important factors that influenced the outcome after the replantation in the presented case included the type and level of injury, ischemia time, comorbidities, age, smoking history, and physical therapy.https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502400044E.pdfamputationtraumatichand injuriesmetacarpal bonesplastic surgery proceduresquality of lifereplantation |
| spellingShingle | Erić Dražan Kovačević Maksim Dostić Milivoje Đorđević-Marić Sanja Kojić Siniša Kapor Slobodan Ninković Milomir Transmetacarpal replantation Vojnosanitetski Pregled amputation traumatic hand injuries metacarpal bones plastic surgery procedures quality of life replantation |
| title | Transmetacarpal replantation |
| title_full | Transmetacarpal replantation |
| title_fullStr | Transmetacarpal replantation |
| title_full_unstemmed | Transmetacarpal replantation |
| title_short | Transmetacarpal replantation |
| title_sort | transmetacarpal replantation |
| topic | amputation traumatic hand injuries metacarpal bones plastic surgery procedures quality of life replantation |
| url | https://doiserbia.nb.rs/img/doi/0042-8450/2024/0042-84502400044E.pdf |
| work_keys_str_mv | AT ericdrazan transmetacarpalreplantation AT kovacevicmaksim transmetacarpalreplantation AT dosticmilivoje transmetacarpalreplantation AT đorđevicmaricsanja transmetacarpalreplantation AT kojicsinisa transmetacarpalreplantation AT kaporslobodan transmetacarpalreplantation AT ninkovicmilomir transmetacarpalreplantation |