We presented a 5-year-old girl who underwent replantation of the left upper arm. Her left arm was severed by a tram at a factory where her mother was employed. The injury was a local crush amputation. Immediate replantation surgery was performed under general anesthesia. The humerus had a double fracture of the shaft. It was shortened 4 cm and fixed with intramedullar Kirschner wires. We sutured the brachial artery, vein and subcutaneous vein with an interpositional vein graft. The ischemia time was about 6 hours. The medial, ulnar, and radial nerves were sutured in an end-to-end fashion. Six months after surgery, functional recovery had obtained grade III of Chen's criteria. One year after surgery, she had achieved grade II recovery on Chen's criteria without additional surgery.The reasons this patient achieved a relatively good outcome within one year might be the young age of the patient and reduction of the misdirection rate by end-to-end suture of the severed main nerve trunks without nerve grafting.
