Replantation of the upper extremity.

In recent years, the functional results after replantation surgery have improved with increased experience. Stiffness remains as the single greatest postoperative problem. Improvements in this area are now possible with aggressive and closely supervised postoperative hand therapy and splinting. The efficiency of the replantation effort itself has increased dramatically in the hands of a number of surgeons experienced in replantation working together as a team. Once vascular flow to an amputated part has been reestablished, the injury is converted to a complex upper extremity injury that would be treated aggressively by many surgeons trained in this discipline. The stigma associated with the amputated part as being one to which function may never be restored has largely been eliminated. One thing is certain ... missing digits never function.