[Unusual case of successful hand replantation with bad functional outcome: a case report].
BACKGROUND
Traumatic hand amputation is a very severe and rare injury. Replantation and revascularization surgery requires the existence of specialized centres and well-educated teams of microsurgeons. In places where there are no such specialized centres for this kind of surgery, traumatic hand amputation is a major concern and quite a challenge, and a successfully performed replantation is a great accomplishment.


METHODS
We report a case of a successfully survived replanted hand in a 35-year-old male patient with unfortunately bad end result of the treatment. The patient with the amputated left hand (disarticulation) had a surgery 4 hours after injury. The urgent surgical procedure required a debridement, the excision of the first row of the carpal bones, external fixation of the wrist, vascular anastomoses, nerve repair, tenorrhaphy, skin sutures and decompression skin incisions.The successful operation did not have a successful post-operative course due to the patient's psychiatric problems and lack of rehabilitation at the psychiatric institution where the treatment was continued.


CONCLUSIONS
Successful surgical performance can unfortunately be ruined due to inadequate further treatment course or the wrong selection for such a demanding surgery. The survival of the amputated hand can be achieved surgically, but achieving refunctioning does not always depend on surgery. It also depends on the very patient, his motivation, rehabilitation, as well as on the proper selection for such a demanding and complex surgical procedure.
Saša
S
Milenković
Ljiljana
L
Paunković
Milan
M
Višnjić
Predrag
P
Kovačević
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011182:Postoperative Care; D012092:Replantation / Q000379:methods; D016896:Treatment Outcome