Venous graft and volar venous anastomosis in distal phalanx replantation

Abstract

Objective To explore the methods of distal finger replantation at different levels.Methods Sixty-three cases with 71 fingers severed at distal phalanx level were replanted from 2004 to 2007.The distal phalanx was divided into 4 zones as described by lshikawa.Vein grafting and anastomosis of volar distal veins were employed according to the injury zone. Results Seventy replanted fingers survived.FoUow-up ransed from 3 months to 3 years.The replanted fingers had full pulp and normal length.Nail growth Was normal.Two-point discrimination was 6.5 mm on average.Except cases with zone Ⅳ iniury in which arthredesis was-done,the average range of motion of the interphalangeal joint Was 69°. ConclusionIn distal finger replantation venous graft is necessary in order to maintain the length of the finger and preserve the nail.This is especially true in zoneⅡand zone Ⅲ injuries.Anastomosis of volar veins is key to replantation survival. Key words: Finger injuries; Microsurgery; Replantation; Distal phalanx; Venous graft