With the recovery of sensation and strength in two cases in which an arm was reunited with the body after complete accidental amputation, one case followed for over two years, replantation seems to be a reasonable operation for certain patients under certain circumstances. The patient must be one who would benefit more from his own arm, however imperfect, than from rapid rehabilitation with a prosthesis; his injuries must largely be limited to the arm. The hospital must be capable of providing the resources necessary to a good result without compromising the care of patients with the more usual illnesses. The surgical procedures themselves are in large measure the sum of those commonly applied to reconstruction of the individual parts, but there are some special considerations with respect to (1) preserving the limb by hypothermia until circulation is restored, (2) fixation of the bone, (3) the vascular anastomoses, and (4) management of soft-tissue injury.
Malt RA, McKhann CF. Replantation of Severed Arms. JAMA. 1964;189(10):716–722. doi:10.1001/jama.1964.03070100010002