What's new in hand surgery

This article reviews material presented at the 2000 Annual Meetings of the American Society for Surgery of the Hand, the American Association for Hand Surgery, and the American Academy of Orthopaedic Surgeons as well as articles published in the field of hand surgery between August 1999 and July 2000. During that time, much interesting and important material had appeared, but perhaps none is more interesting or controversial than that related to the new prospect of hand transplantation. On September 23, 1998, in Lyons, France, the distal aspect of the right forearm and the right hand of a brain-dead forty-one-year-old motorcycle-accident victim was transplanted to the right forearm of a forty-eight-year-old man who had had a traumatic amputation of the right hand some years previously. Immunosuppressive therapy included prednisone, mycophenolate, mofetil, FK-506, and antithymocyte globulins. On January 24, 1999, a second transplantation was performed in Louisville, Kentucky. Additional hand transplantations, including at least one bilateral procedure, were performed subsequently in other parts of the world. To date, all of the transplanted parts are viable, and, in the case of the patient in Louisville, there has been some evidence of functional recovery. However, the original transplant recipient recently requested that the transplanted hand be amputated, partly because of loss of function and partly because of side effects of the antirejection drugs, which included diabetes, nausea, and weight loss.