REPLANTATION ARM

FIRST SUCCESSFUL PROXIMAL ARM REPLANTATION IN INDIA 1984
25 YEARS FOLLOW UP THROUGH ELBOW PROXIMAL ARM REPLANTATION IN 1984 26 YRS FOLLOW UP

Master AA, a young boy aged around 3 years, had an accident on 13.7.82 at around 02.30 PM at Pune (about 100 miles away from Bombay), wherein he had a total amputation through elbow of his left arm. On way, they were instructed to preserve the amputated part suitably and to keep the patient well hydrated. By the time he reached to the hospital, his limb was rigid with Rigor Mortis Microsurgical exploration and preparation of the amputated part and the stump was performed under general anesthesia and all the steps for replantation were undertaken:

A. Bony fixation using Intra-medullary nail.
B. Anastomosis of Brachial Artery.
C. Anastomosis of veins. (Two Veins of adequate size.)
D. Co-optation of ulnar and median nerves.
E. Repair of Flexor / Extensor compartment.
F. Loose closure of skin or skin graft if under tension.
G. Fasciotomy of skin and deep fascia in the amputated part to avoid development of compartment compression syndrome following muscle edema and venous engorgement.

It was around 7.00 AM the next day that complete Replantation of the limb could be accomplished. The color of the forearm, wrist, palm and fingers gradually started turning pink and there was a brisk capillary bleeding from all fingers on needle prick. The Patient did not develop any systemic complications nor had any major wound sepsis.

I am very happy to inform that the patient has recovered completely with a fully surviving limb. He has been followed up for 26 years and has become a man of 31 years and is using the limb in all his daily activities. It was a rare and difficult surgical feat to replant a proximal major amputation of the arm in a child of three years successfully.