A 1998 narrative review synthesizing the replantation literature to guide initial treating physicians—outside hand centers—on which patient, injury, and logistical factors determine whether a traumatic digit or hand amputation should be referred for replantation versus managed with revision amputation.
When you encounter a traumatic digit amputation, zone II injury (proximal to FDS insertion) in a single non-thumb digit is a contraindication to replantation — not just a relative one — because adhesion-limited PIP motion leaves patients worse off than revision.
The thumb, pediatric patients, and multiple-digit amputations remain the clearest replantation indications regardless of level.
A 1998 narrative review synthesizing the replantation literature to guide initial treating physicians—outside hand centers—on which patient, injury, and logistical factors determine whether a traumatic digit or hand amputation should be referred for replantation versus managed with revision amputation.
When you encounter a traumatic digit amputation, zone II injury (proximal to FDS insertion) in a single non-thumb digit is a contraindication to replantation — not just a relative one — because adhesion-limited PIP motion leaves patients worse off than revision.
The thumb, pediatric patients, and multiple-digit amputations remain the clearest replantation indications regardless of level.