J Korean Soc Microsurg.  2007 Nov;16(2):75-81.

Microsurgical Replantation of Very Distally Amputated Finger

• Kang HD
• Kim JJ
• Lee NH
• Yang KM
• Moon JH

Abstract

INTRODCTION: Microsurgical replantation of amputated digit have become common procedure in recent years. However replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. So, fingertip amputation was covered by volar V-Y flap, composite graft, cross finger flap and groin flap. But patients who have been treated by these methods experience shortening of digit, nail deformity, excessive tenderness and persistent pain. Replantation could solve most of these problems. MATERIAL & METHODS: In our department, from March 2004 to August 2007, 36 digits in 32 patients with complete amputation at distal to nail base were replanted using a microsurgical technique.
RESULTS
The overall survival rate of the replanted finger was 75%. Venous anastomosis was possible in 8 cases and impossible in 28 cases. In latter cases external bleeding technique was applied with medical leech.
CONCLUSION
After replantation, a few patient complained decreased sensibility, nail deformity and cold intolerance. But most of patients were satisfied with the functional and cosmetic appearance of the viable replanted digits. We believe the replantation should be the first choice in fingertip amputation

Keyword

Replantation; Fingertip

MeSH Terms

Amputation
Arteries
Classification
Congenital Abnormalities
Fingers*
Groin
Hemorrhage
Humans
Replantation*
Survival Rate
Transplants
Veins