Clinical efficacy of replantation after shortened for segmental destructive amputated fingers/thumbs

XING Dan-mou; REN Dong; FENG Wei; WU Fei; PENG Zheng-ren

Abstract：Objective To investigate the efficacy of replantation of segmental amputated fingers /thumbs. Methods Twenty-two amputated fingers in 18 patients were replanted in our hospital from Mar .2004 to Jan.2013 (14 males and 4 females;mean age,33.2 years;range,6 to 56 years).Among them,there were 5 cases of thumb amputation,8 cases of index finger amputation ,4 cases of middle finger amputation as well as ring finger amputation and 1 case of thumb amputation .To make the metacarpophalangeal joint ( MCJ) intact,the debridement was per-formed with uttermost preservation of tissue nearby the joint .For destructive amputated finger at the proximal and middle phalanx level with the base of proximal phalange survived ,the base was reserved for at least 0.5cm to pre-serve its integrity.The thumb was longer than 2cm after replantation.The defect of blood vessels was repaired by free graft of autologous veins .Nerve graft was performed in case of nerve avulsion .The amputated digital nerves were anastomosed to common digital nerves in an end-to-side fashion.Results All cases were shortened and re-planted except for one with destructive amputation of index finger and middle finger ,who underwent heterotopic re-plantation.The survival rate was 90.48 percent.The fingers were shortened for an average of 2.1cm(range,1.2 to 3.5cm).The patients were followed-up for 18 to 51 months.The overall excellent and good rate was 68.42%. Conclusion The outcome of the cases demonstrates that replantation should be attempted for segmental amputated fingers with intact metacarpophalangeal joint and nerve restoration potentiality .