The Journal of hand surgery
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Thirteen consecutive transmetacarpal replantations and revascularizations in 12 patients were reviewed retrospectively. Ten patients (11 hands) sustained crush injuries, 1 withstood an explosive blast, and 1 suffered a guillotine amputation. Nine revascularizations (1 thumb and 31 fingers) and 4 replantations (1 thumb and 16 fingers), including bilateral procedures in 1 patient, were performed. ⋯ Only 1 patient resumed his prior occupation (as supervisor); 2 were permanently disabled, 3 pursued new and unrelated occupations, 2 were still in therapy, and 4 were lost to late follow-up evaluation. None of the manual laborers (11 patients) were able to return to their preinjury livelihood. Despite these discouragingly poor results, all patients were satisfied with the surgery.