HS01IMPROVING FUNCTIONAL OUTCOME POST-REPLANTATION OF THE WRIST

The first published successful clinical replantation of the upper limb was first described by Malt and McKhan in 1962. Together with the refinement of reconstructive microsurgical technique, replantation of the upper limb at various levels has progressed at an astonishing rate and is now widely practiced worldwide. The vast majority of research into replantation of upper limb focuses on the digit. At the level of the wrist, the problems of failure of microsurgical anastomosis and tendon adhesions to pulley systems are less pronounced. However functional impairment as a result of the laceration of all tendons and nerves to the hand and bony misalignment is more marked. We outline theses issues with a case report of a 33 years old man who, in a self harm attempt amputated his left hand with a saw. He underwent a primary surgery to replant his hand, and subsequent surgery to improve function to his hand. In particular, we describe the dilemma of tendon transfer to improve opposition of the thumb, vital to fine pincer grip. [PUBLICATION ABSTRACT]