Abstract
Combined major injury to both upper extremities, in which one hand is amputated and
structurally intact but not replantable, and the other hand is unsalvageable, is a
rare setting in which cross-hand replantation may be considered. We report a case
of an emergency cross-hand replantation performed at the wrist level. In our case,
insertions of the wrist flexor and extensor tendons at the second and third metacarpal
bases were retained at the recipient, allowing for early active wrist motion and finger
motion by tenodesis. Fascicle-specific nerve coaptations were performed. The patient
achieved satisfactory functional results, allowing him independence with daily living
activities and return to gainful employment. At the time of telemedicine follow-up
at 5 years, he was employed full-time, reported no difficulty or mild difficulty with
most daily activities, and preferred the use of his replanted hand over a contralateral
prosthesis.
Keywords
cross-hand replantation - replantation - mangling injury
