So it's definitely not because hand surgeons are lazy or because insurance won't cover it. We actually attempt replantation routinely, and the general indications are as follows: -any finger in a child -multiple digits in an adult -any thumb. 😷 Some surgeons will attempt single-digit replantations as long as they are distal to the flexor digitorum superficialis insertion. 🚨 So why don’t we replant every single digit? The main issue is stiffness and the inability of nerves to fully regenerate when they are completely lacerated as in an amputation. While children do have the ability to regenerate nerves reasonably well, as we get older that ability diminishes. Often after finger replantation in an adult, the finger becomes stiff and lacks sensation, which can impede function of the entire hand. So in certain cases, the hand will actually work better overall if you do not try to replant the digit. 👉 Other reasons we may not be able to replant a digit involve the mechanism of in...