Question

The first structure to be fixed after amputation (during replantation) is?

• A. Bone fixing
• B. Arterial repair
• C. Venous repair
• D. Nerve repair

Hint:

You need a stable, correctly-lengthened scaffold before any microsurgical repair.

Answer 1

The Correct Option is A

The logic of replantation surgery is to build from the inside out, starting with the most rigid structure and ending with the softest. After a traumatic amputation in which the part is judged salvageable, the surgeon must first create a stable, correctly shortened skeletal framework before any soft tissue can be reconnected without tension. That first step is osteosynthesis, the fixation of bone, typically achieved with Kirschner wires. Only when the bone is secured and the limb length is set can the tendons (extensor then flexor) be repaired, after which the operating microscope is used for the artery, then the nerve, then the vein, with skin closure and splinting last. If one tried to repair the millimetre-sized artery, vein, or nerve before stabilising the bone, any movement would disrupt the fragile microsutures, so bone fixation logically and surgically precedes everything else. Among the options, arterial, venous, and nerve repair are all microsurgical steps that come after the skeleton is stable, leaving bone fixing as the first structure addressed. $\text{Order: bone} \to \text{tendon} \to \text{artery} \to \text{nerve} \to \text{vein} \to \text{skin}$.
\[\boxed{\text{Bone fixing}}\]