Microsurgical Replantation of Very Distally Amputated Finger

Kang,  Hong Dae; Kim,  Johng Jin; Lee,  Nae Ho; Yang,  Kyung Moo; Moon,  Ji Hyun

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Original Article

Journal of the Korean Society for Surgery of the Hand 2007;16(2):75-81.
Published online November 30, 2007.

Microsurgical Replantation of Very Distally Amputated Finger

Hong Dae Kang, M.D., Johng Jin Kim, M.D., Nae Ho Lee, M.D., Kyung Moo Yang, M.D., Ji Hyun Moon, M.D.*

¹Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University, Jeonju, Korea. leenaeho@moak.chonbuk.ac.kr
²Department of Plastic and Reconstructive Surgery, Inno Hospital, Jeonju, Korea.

통신저자: 이 내 호 전라북도 전주시 덕진구 금암동 634-18 전북대학교병원 성형외과 Tel: 82-63-250-1860, Fax: 82-63-250-1866, E-mail: <a href="mailto:leenaeho@moak.chonbuk.ac.kr">leenaeho@moak.chonbuk.ac.kr</a> ─ 75 ─ 수지 첨부

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¹
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Abstract

Introduction: Microsurgical replantation of amputated digit have become common procedure in recent years. However replantation of fingertip amputation, Zone I by Yamano classification, is still difficult because digital arteries branch into small arteries and also digital veins are hard to separate from the immobile soft tissue. So, fingertip amputation was covered by volar V-Y flap, composite graft, cross finger flap and groin flap. But patients who have been treated by these methods experience shortening of digit, nail deformity, excessive tenderness and persistent pain. Replantation could solve most of these problems.
Material & Methods: In our department, from March 2004 to August 2007, 36 digits in 32 patients with complete amputation at distal to nail base were replanted using a microsurgical technique.
Results: The overall survival rate of the replanted finger was 75%. Venous anastomosis was possible in 8 cases and impossible in 28 cases. In latter cases external bleeding technique was applied with medical leech.
Conclusion: After replantation, a few patient complained decreased sensibility, nail deformity and cold intolerance. But most of patients were satisfied with the functional and cosmetic appearance of the viable replanted digits. We believe the replantation should be the first choice in finger tip amputation

Key Words: Replantation, Fingertip

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