transplantation of a full-cut upper limb from the middle third of the arm

background: complete traumatic amputation of upper limb from the middle third of the arm is extremely rare. during the past years thanks to advances in scientific and microscopic methods, peripheral nerve surgery has increased the success rate of such surgeries. case presentation: a 2.5 yr-old girl sustained 1/3 proximal end of her right arm amputation. amputated limb had irregular borders and was frozen in a container brought with ice for about three hours. the patient was admitted in the emergency ward of taleghani hospital.  she was completely conscious. her blood pressure was 80/50 ml and her heart beat was 130/mnts. after resuscitation, the amputated limb was cleaned. at first, fractured humerus bone was fixed by plaque and screw. then all muscles and tendons were statured. vessels were anastomosed by end to end and musculocutaneoum nerves have been fixed. at last, fasciotomy and skin repair have been performed. conclusion: the 24 months follow up of the patients’ conditions revealed that the patient had touching sense, temperature and blood pressure in the replanted part and the operation was to a large extent satisfactory.