Clinical analysis of 86 cases of replantation of amputated distal fingers

Abstract

Objective To summrize the clinical results of replantatiion of 126 amputated distal fingers in 86 patients. Methods The amputated part was debridod under 16X high power magnification. Kirschner wires were uniformly used for bony fixation. Tendon repair was carried out next. Severed distal fingers were revasculafized with different kinds of operations according to type Ⅰ, type Ⅱ and type Ⅲ classification of the distal parts. Vein grafts were used in cases of venous or arterial gaps and continuous external bleeding was used in finger replantation with no venous anastomosis or venous congestion after the operation. Results All 114 replants survived uneventfully. The success rate of replantation was 90.5%. Follow up was carried out and showed that the successfully replanted fingers had good soft-tissue coverage and recovery of pain and touch sensation. Two-point discrimination of the finger pulp was 6 to 8 mm. The distal interphalangeal joint had normal flexion and extension. Conclusion The amputated distal fingers should be replanted whenever possible because it provides good appearance and maintains good joint motion. Vein grafts should be used in cases of venous or arterial gaps. Continuous external bleeding could be applied to enhance the survival rate of the replanted finger when no venous anastomosis was done or venous congestion occurred after the operation. Key words: Replantation; Finger injuries; Distal fingers