Abstract: Distal Phalanx Replantation Using Delayed Venous Repair

Abstract

INTRODUCTION: Vein anastomosis is the most important factor determining the success in the replantation of distal phalanx amputations. The purpose of the study was to show that the delayed venous method provides a higher success rate in distal phalanx replantations and does not require use of specialized techniques. METHODS: The delayed venous method for vein anastomosis was used for the last 2 years. This surgical procedure includes initial arterial anastomosis, delayed expansion of the vein, and subsequent vein anastomosis. We have chosen to delay for at least one hour the veins repair, in order to allow the veins to expand to a more reasonable diameter for repair. RESULTS: The delayed method was used in 7 cases. Expansion of veins up to 1 mm or more resulted in a high success rate (71%). In contrast, the success rate for distal phalanx replantation is extremely low in other techniques, because of the difficulty of vein finding and anastomosis. CONCLUSION: It is very difficult to find the collapsed veins and to perform vein anastomosis immediately after arterial repair. The delayed venous method allows easier anastomosis of the subdermal veins of the distal phalanx. Therefore, it is a useful operative technique for treatment of amputated distal phalanx amputation.