A case of salvage of the hand of a thirteen-year-old boy after near total, distal, transmetacarpal amputation is presented. Functional return despite a very limited repair was unexpectedly good, including a useful range of motion in all digits and excellent re-establishment of tactile sensibility. Initial surgery included only crude tendon coaptation and mere placement of the severed nerves in end-to-end alignment. All indicis is proprius transfer and realignment of the ulnar digits were done seven years after injury to provide a stable thumb-index pinch and correct ulnar drift.