Application of modified arterial venalization in replantation of distally severed finger at nail root without venous anastomosis

Abstract

Objective To introduce an improved method of reconstructing venous reflux in replantation of distally severed finger at nail root, and explore its clinical efficacy. Methods From January 2016 to September 2018, 12 patients with 13 distally severed fingers at nail root were replanted. There were no veins to anastomose the two severed ends. The proximal bilateral proper digital artery was anastomosed with the distal digital artery or two branches. The proximal digital artery was cut off and anastomosed with the proximal dorsal digital vein to establish venous reflux. Results In 13 replanted fingers, 1 finger had partial necrosis due to serious tissue contusion, and the other 12 fingers survived completely. No venous crisis occurred after operation. The postoperative follow-up time ranged from 3 to 9 months with an average of 6.0 months. The skin texture of replanted finger was good, the nail grew well, and the sensation recovered to over S3. The patient was satisfied with the appearance and function. Conclusion The modified arterial venalization can effectively solve the venous reflux problem in venous deficiency and improve the survival rate of replantation of distally severed finger at nail root. It is an effective way to reconstruct venous reflux in the absence of severed veins. Key words: Replantation; Treatment outcome; Arterial venalization; Venous reflux