Since 1963 when Chen – Zhong – Wei in China first replanted a distal forearm amputation, the number of revascularized extremities has tremendously increased. Management of proximal to the wrist amputation is critically depended upon the meantime from injury to revascularization. Cool ischemia must not exceed 6 – 8 hours. Factors like the level and type of amputation, age of the patient as well as concomitant injuries must also be considered in decision – making.

From 1988 to 2001, 16 patients who sustained amputation (10 patients with wrist amputation, 6 distal forearm amputation) had successfully been treated at our institution. 13 patients were male and 3 female. Mean age was 38 yrs (varying from 17 to 55 yrs). 14 patients sustained complete amputation, where as 2 patients incomplete non-viable amputation. The vast majority of amputations were due to injury by disk saw, 2 by rotating belt, 1 by a propeller and 1 by a heavy metal sheet.

All patients underwent an emergency operation within less than 6 hours. Bone shortening was performed in a few cases using as internal fixation device, plates associated with k-wires.

Our principal goal was the primary reconstruction of all anatomical parts in order to resume as soon as possible an intense rehabilitation program.

All patients except one achieved satisfactiry function. According to Chen criteria were classified as: · 3 pts in class I · 10 pts in class II · 2 pts in class III · 1 pt in class IV

According to subjective evaluation all patients were satisfied, including the one with poor functional outcome and no one was willing to sudstitute his extremity for any prosthetic device.