MAJOR LIMB REPLANTATION IN CHILDREN

After the first successful replantation of a completely amputated extr emity in a 12-year-old boy undertaken by Ronald Malt at the Massachuse tts General Hospital in 1962 (Malt and McKhann, Journal of the America n Medical Association, 189:716-722, 1964) numerous series of major lim b replantations have been reported in adults. The reports of major lim b replantation in children are relatively rare and are usually include d in adult series. During the last 14 years, 18 children with major li mb amputations were treated at the Microsurgical and Replantation Unit of the Department of Orthopaedic Surgery at the University of Ioannin a Medical School. Of these, 13 were complete amputations (11 upper ext remity and 2 lower extremity), while 5 were incomplete nonviable amput ations (3 upper extremity and 2 lower extremity). The success rate fol lowing replantation of the complete amputations was 76.9%, while for t he incomplete, nonviable amputations success was 80%. Preoperative eva luation, operative management, postoperative care, and the results of this difficult but rewarding procedure are analysed and discussed in t his review. (C) 1994 Wiley-Liss, Inc.