Techniques of bone fixation and clinical experience in replanted extremities.

Bone is shortened only enough to obtain skin closure or to remove excessive local comminution. Shortening is never done solely for the purpose of obtaining vessel apposition since vascular damage may extend beyond the zone of general soft tissue involvement. Fixation should be rapidly accomplished and be reasonably stable. Techniques are described. Following bony fixation, repair of flexor tendons and then nerves is carried out. Vessel repair using vein grafts to make up defects is then accomplished followed by loose skin closure.