Abstract
The fingertips are important for not only the function of the hand but also cosmetic reasons. In distal phalanx, arteries especially in zone …Ÿ are less than 0.5 mm in diameter however they can be anastomosed ultramicro-surgically with 11-0 suture.
From 1976 to 1999, I have replanted 463 digits in 337 male and 126 female patients whose ages ranged from 4 months to 80 years, with an average of 32.7 years. There were 312 digits with complete amputation, 151 digits of incomplete amputation, 277 digits with trauma in zone …Ÿ and 186 digits in zone … in which more than six months had passed since the replantation.
The results in zone … amputations was better then in cases of amputations in zone …Ÿ because anastomoses of arteries and viens are more relibale in zone … amputation.
I analyzed the results of zone …Ÿ amputation according to types of injury. The survival rate was 100% in clean-cut amputation, 91.7% in blunt-cut, 66.1% in crush and 67.5% in avulsion. So in cases of crush or avulsion amputation in zone …Ÿ, there is relative indication for replantation.
As for postoperative functional recovery, 95% of the survival fingers are in good daily use, or in some use. Compared with stump plasty, our results of survival fingers are far superior functionally and cosmetically. From a survival rate and functinal point of view, replnatation is definitely indicated in cases of zone …Ÿ amputations by clean-cut or blunt-cut and zone … amputations if technically possible.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
