The efforts of surgeons to salvage and reimplant severed or traumatically amputated extremities date far back in time. In 1903, Hoepfner, in performing experiments on arterial anastomoses, transected and reimplanted a series of dogs' limbs without dividing the bone, sciatic nerve, or femoral vein. Thrombosis of the artery under these conditions led to a high incidence of gangrene.1 Carrel and Guthrie continued these studies with thoughts of human extremity transplantations.2
Although various techniques for limb transplantation have been used by several investigators during the study of vascular anastomoses, grafts, and survival of ischemic tissue, publications dealing with the reimplantation of totally amputated extremities are extremely limited. Lapchinsky reported excellent long-term results after immediate replantation of autogenous canine hind limbs amputated at midthigh level, as well as successful restoration of limb function after 28 hours of storage.3 Snyder also reported successful replantation of canine hind limbs, using a