Microsurgical basics of digital replantations

In 1965, Komatsu and Tamai reported the first successful digital replantation. For more than 40 years, the limits have continued to be pushed thanks to technological advances and surgical techniques which have considerably improved the success rates of digital replantations. Microsurgical expertise and specialized training programs have played a crucial role in improving surgical outcomes and expanding the scope of replantation surgery to include complex cases such as thumb replantations, pediatric cases and very distal finger amputations. Additionally, the establishment of specialized centers for emergency hand surgery, such as those in the FESUM network, has facilitated access to comprehensive and timely care for patients with traumatic hand injuries requiring replantation. Although digital replantation has become a common procedure, vascular survival is only one aspect of success. Functional outcomes, including sensory and motor recovery, are equally important considerations in assessing the overall success of surgery. Rehabilitation strategies tailored to individual patient needs are essential to optimize functional recovery and restore hand function. In summary, this update provides an overview of the current state of digital replantation surgery, emphasizing the importance of careful surgical technique, patient selection and postoperative care to achieve successful results and minimize complications.