Heterotopic transplantation of a reattached digit.

A patient who had suffered amputations at different levels of his nondominant left hand, and who had initially been treated with reattachment of his index and long fingers, presented with a minimally functional left hand. He was then managed by transplantation of his reattached index finger stump to the shortened ring finger. This significantly improved hand function and contour and alleviated a painful neuroma at the former ring finger amputation site. However, compared with the long finger, which was reattached once, the twice-reattached finger had less sensibility recovery, more pronounced cold intolerance, decreased basal skin temperature, and a slower digital rewarming time. Thus, even though it is technically feasible to transfer a previously reattached digit, other possible physiologic limitations must be considered before doing so.