Replantation of hand multi-level severances with 17 segments

Abstract Traumatic injuries of the hand and fingers might be devastating with irretrievable functional and psychological consequences in injured individuals. We present a case of successful replantation of hand multi-level severances with 17 segments to address the best way of treatment of such injury. The patient was 18-year-old female with multi-level severances due to cutting injury. During the surgery, we adopted unifying coordination and grouping surgery. Moreover, we tried to improve the quality of vascular anastomosis with various measures and shorten operative time. Postoperatively, we closely observed the patient to effectively prevent and treat vascular crises. Furthermore, we acquired utmost hand function recovery through enhancing functional rehabilitation exercise. The case was followed-up regularly. As a result, the replanting palm and all fingers survived successfully. Abdominal pedicle flaps were used to repair the skin of the distal end portion of thumb and middle finger due to severe injury. At 5-year follow-up, the prehension function of the hand was restored and the patient was capable of general labour and normal activity with the replanted hand. This report demonstrated our experience of successful treatment of a rare and severe case of hand injury. Accordingly, we recommend grouping surgery, closely coordination, effective and comprehensive intra-operative and post-operative technical operations and treatments. Postoperative functional rehabilitation exercise can restore utmost hand function.