Fifteen years ago I had an accident driving a team of mules. Three of my fingers were pulled off at the middle knuckle. If this happened today, could my fingers be saved?

Reattaching fingers traumatically amputated is called replantation. This type of procedure is possible but not always available where patients in need of it live. It requires a highly skilled surgeon trained in microsurgery. The right surgical equipment is also needed.

The nerves and vessels are repaired with special surgical instruments. While the patient is sedated, the bone ends are shortened to remove tension on the repaired blood vessels. The finger or toe is put in place and the bone is stabilized with wires or a plate and screws. Then any tendon repairs are done.

Replantation of an amputated part is best done within four to six hours after the injury. However, success has been reported up to 24 hours after the injury if the amputated part has been cooled and protected.

Replantation is possible when the fingers or toes are in a condition that would allow restoration of the blood and nerve supply. Children are especially good candidates for replantation surgery. They have a greater potential for healing and regenerating tissue.

Under the right conditions, the long-term prognosis for the restoration of use in the finger or toe is very good.