Cross-hand Replantation Achieved at RGGGH Chennai

Breakthrough Surgery at RGGGH

Cross-hand Replantation Achieved at RGGGH Chennai: A team at Rajiv Gandhi Government General Hospital (RGGGH), Chennai, performed a rare and complex procedure known as cross-hand replantation, where the amputated left hand of a 28-year-old man was attached to his right forearm stump.
The patient, a migrant labourer from Bihar, had suffered a train accident on 26 September in which his left arm was lost near the shoulder (too crushed for normal reattachment) and his right hand had lost all fingers.
Faced with potential total upper-limb loss, the surgical team opted for a cross-limb solution to restore at least one functional limb rather than conventional replantation that was not feasible.

Significance of the Procedure

This is the first time this kind of surgery was performed in a government hospital in India and only the second reported case in the country, while globally such procedures are extremely rare — about four reported cases worldwide.
The operation spanned around 10 hours and involved skeletal fixation, tendon reconstruction, and microvascular repair of arteries, veins, and nerves. Surgeons observed immediate blood flow in the transplanted hand after re-vascularisation.
It underlines both the advancement of microsurgical reconstructive capabilities in public health institutions in India and the commitment to complex trauma care irrespective of cost considerations.

Static GK fact: The Rajiv Gandhi Government General Hospital in Chennai was founded on 16 November 1664 and is recognised as India’s first modern hospital.

Challenges and Rehabilitation

The success of such surgery depends heavily on post-operative care — nerve regeneration, tendon healing, functional rehabilitation (physiotherapy), and the patient’s brain re-adapting to the transplanted limb.
The RGGGH team also had to overcome non-medical hurdles — the patient could not communicate in Tamil or English and had no attendant, so they arranged Hindi-speaking residents to explain the procedure and secure consent.

Why This Matters

• It demonstrates that complex limb salvage surgeries are moving into government institutions, making high-end reconstructive care more accessible.
• It sets a precedent for microsurgical teams across India to consider innovative solutions when standard replantation is impossible.
• It emphasises the need for robust trauma systems, multidisciplinary teams (plastic surgery, orthopaedics, vascular surgery, anaesthesia), and long-term rehabilitation infrastructure in public hospitals.

Static GK Tip: Microsurgery in India made significant strides with pioneers like Prof. S. Raja Sabapathy, whose team reported a cross-hand replantation in Coimbatore in 2020.

Outlook

While anatomical continuity has been restored, the functional recovery of the patient will take months or even years of dedicated physiotherapy and monitoring. The success also hinges on infection control, patient motivation, and continued follow-up.
In the long run, this case may spur stronger focus on limb trauma centres, public hospital microsurgery programmes, and training of specialists in reconstructive techniques in India.

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Cross-hand Replantation Achieved at RGGGH Chennai: