The Role of Traditional Limb Salvage and Finger Replantation in the Era of Bionic Reconstruction.

Hand Clin · Aug 2026 · Review

Kawamura K, Chung KC

Michigan Medicine, Ann Arbor, MI

Hand & Upper Extremity

SUMMARY — THE REDUCTIONThis review argues replantation still beats revision amputation for thumb, multiple-digit, and distal single-digit amputations, and for distal forearm amputations, with bionic reconstruction a possible alternative when replanted hands function poorly.
Abstract, as published

Replantation is generally recommended for thumb amputations, multiple-digit amputations, and single-digit amputations distal to the flexor digitorum superficialis insertion, because it offers superior functional outcomes compared with revision amputation. Replantation of distal forearm amputations is also considered beneficial, as it results in better postoperative function than prostheses and offers a high likelihood of successful return to work. Elective amputation with bionic reconstruction may be a viable alternative when hand function remains poor, particularly when combined with diminished sensibility following replantation of major upper limb amputations.

Featured in the 2026-09-30 issue.

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