A study of revascularization in thumb replantation

Abstract

Objective To provide more references for the thumb revascularization and improve success rate of thumb replantation through retrospecting and summrizing various revascularization methods in thumb replantation. Methods From August 2013 to October 2015, 20 cases of complete or incomplete thumb severance were replanted. There were complete thumb severance in 17 cases and incomplete one in 3 cases. Severance level at distal phalanx was in 4 cases, at interphalangeal joint in 3 cases, at proximal phalanx in 8 cases, at metacarpophalangeal joint in 2 cases, at first metacarpal bone in 3 cases. There were 12 male and 8 female patients, with a mean age of 37.25 years (range, 12 to 64 years). It depended on the injury mechanism and vascular injury condition to choose the revascularization methods. Results Postoperatively all 20 cases completely survived. All the patients were follow-up for 8 to 36 months, with an average of 16 months. The blood supply and appearance of replantation thumb were satisfactory. The finger pulp was full. The function of opposition and pinch were good. According to the functional evaluation criteria of the finger replantation issued by the Hand Surgery Society of the Chinese Medical Association, the results of replantation thumb were excellent in 12 fingers, good in 6 fingers and fair in 2 fingers. Conclusion Fully familiar with the anatomy and variation of thumb blood supply, preoperative complete evaluation of injury mechanism and severance level, and classification can provide more choice for the reconstruction of thumb function. Key words: Replantation; Thumb; Revascularization; Transplantation