Replantation Surgery

Traumatic amputations of the fingers, hand, or arm are life-altering events that require urgent, specialized care. At the NYU Langone Hand to Shoulder Trauma Center, Dr. Jacques Hacquebord and a dedicated team of fellowship-trained microsurgeons provide 24/7 emergency coverage for replantation — the surgical reattachment of an amputated part.

Our center is one of the few in the region with the expertise, resources, and microsurgical capability to perform complex replantations at all levels of the upper extremity, from fingertips to complete hand or forearm amputations. Our mission is not only to save the limb, but to restore long-term function, strength, and independence.

Replantation requires advanced skill, precision, and rapid coordination. When a traumatic amputation occurs, our team mobilizes immediately to provide the highest level of care.

What Replantation Involves
A replantation surgery reconnects the essential structures of the amputated part, including:

• Bones
• Tendons
• Arteries and veins
• Nerves
• Soft tissue

This intricate microsurgical work aims to restore blood flow, maintain viability, and give patients the best chance of regaining meaningful function.

Who May Be a Candidate?
Replantation may be appropriate for amputations involving:

• Fingers and thumbs
• Multiple digits
• Hand amputations
• Partial or complete forearm amputations
• Sharp lacerations or guillotine-type injuries

Each case is evaluated individually based on the mechanism of injury, ischemia time, and patient factors.

Our 24/7 Trauma Response
As part of NYU Langone’s Level 1 trauma network, the Hand to Shoulder Trauma Center provides:

• Around-the-clock microsurgical availability
• Immediate operating room access
• Vascular, orthopedic, and plastic surgical collaboration
• On-site hand therapy for early rehabilitation

This seamless system ensures that patients receive timely, life- and limb-saving surgery when every minute counts.

While acute replantation focuses on restoring circulation and viability, many patients benefit from secondary reconstructive procedures that maximize motion, dexterity, and strength. These procedures are a normal and expected part of replantation recovery.

Common Secondary Procedures After Replantation
Depending on the level and severity of injury, additional surgeries may include:

Tendon Reconstruction

• Tendon transfers
• Tenolysis (freeing scarred tendons)
• Reconstruction to restore flexion or extension

Nerve Surgery

• Nerve grafting or nerve transfers
• Procedures to improve sensation or motor control

Bone and Joint Procedures

• Osteotomies to realign bones
• Joint stabilization or fusion when needed
• Correction of malunions or nonunions

Soft Tissue Procedures

• Flap coverage for soft-tissue deficits
• Scar revision
• Webspace reconstruction

These staged procedures are designed to enhance the functional outcome of the replant and support long-term use of the hand or limb.

Replantation recovery is a long-term journey that involves:

• Specialized hand therapy
• Strengthening and range-of-motion work
• Sensory re-education
• Personalized rehabilitation goals

Our therapists work hand-in-hand with the surgical team to ensure that each patient progresses safely and efficiently.

For patients with significant bone loss, chronic stiffness, or failed previous surgeries, we offer advanced reconstructive techniques, including:

• Vascularized bone grafts
• Medial femoral condyle (MFC) or medial femoral trochlea (MFT) free flaps
• Nerve transfers to restore key functions

These techniques help salvage limbs and optimize function even after the most severe injuries.

From the emergency department to long-term rehabilitation, Dr. Hacquebord and the NYU Langone Hand to Shoulder Center offer unmatched expertise in replantation surgery and reconstruction.

Our team is committed to guiding patients through every step — acute surgery, recovery, secondary procedures, and rehabilitation — to help restore as much function and independence as possible.