Application of blocking one side of the finger artery in replantation of distal severed finger

Abstract

Objective To explore the application and clinical efficacy of blocking one side of the proximal middle segment digital artery combined with wet dressing of heparin sodium cotton on the nail bed in replantation of distal severed finger, at the nail root of which venous drainage cannot be established. Methods From December 2014 to November 2017, 10 patients with distal finger complete dissection at the plane of nail root were treated by blocking one side of the proximal middle segment digital artery combined with wet dressing of heparin sodium cotton on the nail bed, which established the venous drainage and promoted the survival of the replanted finger. After anastomosing the bilateral digital artery, non-dominant side of the proximal middle segment digital artery was ligated. According to the principle of vascular pressure difference, a part of the dominant side of the finger arterial blood provided nutrition for replanted finger through the arterial arch. Another part flowed to the non-dominant side and enters the venous system through the capillaries in the middle segment. The normal venous system was formed later. Results All the 10 replanted fingers survived. The follow-up period ranged from 3 to 15 months with an average of 10 months. The nail of replanted fingers grew well without deformity. Slightly atrophy of finger body occurred. The sensation recovered to S2to S3+. According to the criteria of functional evaluation of finger replantation issued by the Hand Surgery Society of the Chinese Medical Association, the results were graded as excellent in 8 cases, good in 1 case and fair in 1 case. All the patients were satisfied with the appearance and function of the replanted fingers. Conclusion It is a simple and effective method for improving the survival rate of the replanted finger by blocking one side of the proximal middle segment digital artery combined with wet dressing of heparin sodium cotton on the nail bed, especially for the patients with severe contusion of injured fingers. Key words: Finger injuries; Replantation; Distal fingers; Venous drainage