TRANSPOSED REPLANTATION OF FINGERS AT FOREARM BONES IN SEVERE SEGMENTAL INJURIES ACROSS THE HAND AND WRIST

There are situations in which amputated hands or fingers cannot be rep lanted directly back to their original positions. When there is severe segmental injury across the hand and wrist but one or several fingers are still healthy, the fingers can be selected to be replanted at the forearm bones to restore pinch function. This is different from the t oe to antebrachial stump transplantation presented by Dr. Vilkki. From the results in four patients, the following conclusions are drawn: (1 ) When the fingers are replanted at the forearm bone(s), only pinch fu nction can be obtained. There is no opposition. (2) Grip function is w eak because the intrinsics are lost and only a few fingers are replant ed. The forearm bones are often shortened, as are the flexors. (3) Of particular importance is the creation of a large web space between the radial digit and ulnar digit(s), because fingers are longer than toes . (4) The sensory recovery is not so good as in ordinary finger replan tation. However, this is a salvage procedure. Regardless of these fact s, the patients are still satisfied with the results out of such sever e injuries. With good pinch function, not only are they independent in daily life, but they also can do a lot of work. It is a worthwhile pr ocedure. A functional prosthesis can be added distally after this repl antation.