Successful replantation despite improper storage of amputated thumb: a case report

Gunasagaran, Jayaletchumi and Tan, Y.Y. and Ahmad, T.S. (2022) Successful replantation despite improper storage of amputated thumb: a case report. Malaysian Orthopaedic Journal, 16 (1). 122 -125. ISSN 1985-2533, DOI

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Replantation of fingers is highly complex and technically challenging. Surgeons are serious with their selection criteria as many factors are involved in determining good surgical outcome. Improper storages of amputated parts are usually denied the option for replantation. We report a 42-year-old lady who was assaulted with a machete and presented with total amputation of left thumb. The amputated thumb was stored in a plastic bag directly on ice cubes which eventually melted; thumb immersed in water for two hours. On examination, the amputated thumb was neither macerated nor frozen. Replantation was attempted and was successful. There are limited reports on proper methods of storage of amputated fingers pertaining to daily practical scenario. Yet, it is a strict criterion for surgeons in attempting replantation. Direct contact of amputated fingers on ice and immersion in hypotonic solutions leads to irreversible tissue damage. In our case, two hours of unfavourable storage did not affect surgical outcome. In conclusion, clinical assessment of the amputated part is essential in deciding for replantation. Combination of direct contact with ice and immersion in hypotonic solution for two hours should not be a contraindication for replantation. © 2022, Malaysian Orthopaedic Association. All rights reserved.

Item Type: Article
Funders: None
Uncontrolled Keywords: acetylsalicylic acid; heparin; hypotonic solution; ice; water; adult; anastomosis; Article; case report; clinical article; clinical assessment; digital artery; exercise; female; finger replantation; flexor pollicis longus muscle; grip strength; human; metacarpophalangeal joint; microanastomosis; radiography; range of motion; sensation; skin maceration; storage; surgeon; thumb; thumb amputation; tissue injury; wound healing
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Medicine > Orthopaedic Surgery Department
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 10 Nov 2023 02:18
Last Modified: 10 Nov 2023 02:18

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