Abstract
Failure of replantation is one of the most serious complications in replantation surgery. Management of that unhappy situation is a dilemma in the microsurgical field. These authors performed 9 cases of thumb reconstruction in failed thumb replantations from 1996 to 2002. There was early debridement of soft tissue under necrotic changes, resulting in necrotizing phalangeal bone without any soft tissue. Osteosynthesis of the extracted phalangeal bone was carried out with a living portion of the proximal bone. The exposed bony portion was covered with a vascularized flap such as the reversed radial forearm pedicled flap, free radial forearm flap, and neurovascular island finger flap. This procedure was carried out within a week after vascular insufficiency developed.
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