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Dad lost his thumb in a car accidentlast year. He was 72 then and everyone thought trying to save the thumb at his age would put him at too great a risk. But he's lost the ability to do so many things that he always loved (tie fishing flies, play the piano, shoot skeet). I can't help but wonder what are the odds that a surgery to put his thumb back on would really have killed him? Do you have any idea about this?

Surgeons keep in mind the idea that "life comes before limb" (i.e., don't put someone at risk of death to save a finger). The decision can be a difficult one and often has to be made quickly. Age is taken into consideration along with general health, type of injury (as well as other injuries sustained at the time of the accident), and the functional needs of the patient. The desire to continue doing things like playing the piano or tying fishing flies may not come up at the time of the accident and injury. Shock, panic, and fear take center stage. According to a recent study from the Department of Reconstructive Surgery at Stanford University (California), age is not a reason to rule out finger or thumb replantation. Older adults (over age 65) were not found to be at greater risk of death with replantation surgery. Oh, to be sure, there were complications in this age group. Blood clots, bleeding, pressure ulcers, and accidental cuts were reported. But the percentage of patients affected was less than one per cent (0.6 per cent). Death occurred in an even smaller number (0.04 per cent). And some folks couldn't be discharged to home and had to go to a nursing home. But overall, age should not be a reason to avoid replantation.

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