Abstract
INTRODUCTION: Dog bite injuries are common, but dog bite avulsion amputations are rare, and in the paediatric population, they are even rarer. We report a successful thumb replantation in a 2-year-old girl following avulsion amputation from a dog attack, representing one of the youngest cases to date, and review relevant literature to emphasize the importance of multidisciplinary management. CASE REPORT: A 2-year-old girl presented with complete thumb avulsion at the proximal phalanx after a dog bite, having also sustained a prior bite one week earlier. . Multidisciplinary consensus involving plastic, orthopaedic, and infectious disease consults supported replantation. The procedure included thorough debridement, skeletal fixation, vascular and nerve repair, with empiric broad-spectrum antibiotics.. At 18 months follow-up, the child achieved full functional recovery: zero VAS pain, restored grip strength, near-normal range of motion, and excellent standardized scores (Tamai, QuickDASH). Age-appropriate psychosocial adjustment was confirmed by YCPC and PedsQL. CONCLUSION: This case demonstrates that replantation can be feasible and successful in select paediatric dog bite-related amputations despite contamination, when supported by aggressive debridement and infectious disease-optimized care. The outcome highlights the regenerative capacity in children and reinforces the role of multidisciplinary management in expanding replantation indications for contaminated traumatic injuries.