RSS-Feed abonnieren
DOI: 10.1055/s-2006-947694
Results of Replantation of Amputated Fingertips in 450 Patients
Publikationsverlauf
Accepted: April 19, 2006
Publikationsdatum:
07. August 2006 (online)
ABSTRACT
Over a 15-year period (August, 1988 to May 2003), the authors have carried out 510 replantations of amputated fingertips distal to the nail base (zone I) in 450 patients, with a high overall survival rate (92 percent), using combinations of arterial and venous anastomoses without any alternative methods such as “pocketing.”
Replantations that anastomosed only one artery (25 digits) had a success rate of 68 percent, one artery and one vein (115 digits) had a success rate of 82 percent, one artery and two veins (240 digits) had a success rate of 95 percent and more than two artery and vein anastomoses (130 digits), had a success rate of 99 percent. The follow-up period ranged from 3 months to 14 years and 432 patients were followed-up more than 6 months. In these latter patients, the average two-point discrimination was 7 mm.
KEYWORDS
Fingertip - amputation - replantation
REFERENCES
- 1 Malt R A, McKhann C F. Replantation of severed arms. JAMA. 1964; 189 716-722
- 2 Komatsu S, Tamai S. Successful replantation on a completely cut-off thumb. Plast Reconstr Surg. 1968; 42 374
- 3 Kim K S, Eo S R, Kim D Y, Lee S Y, Cho B H. A new strategy of fingertip replantation: sequential use of microsurgical technique and pocketing of composite graft. Plast Reconstr Surg. 2001; 107 73-79
- 4 Lee P K, Ahn S T, Lim P. Replantation of fingertip amputation by using the pocket principle in adults. Plast Reconstr Surg. 1999; 103 1428-1435
- 5 Lin T S, Jeng S F, Chiang Y C. Fingertip replantation using the subdermal pocket procedure. Plast Reconstr Surg. 2004; 113 247-253
- 6 Tsai T M, Mccabe S J, Maki Y. A technique for replantation of the finger tip. Microsurgery. 1989; 10 1-4
- 7 Yamano Y. Replantation of fingertips. J Hand Surg Br. 1993; 18 157-162
- 8 Kim W K, Lim J H, Han S K. Fingertip replantations: clinical evaluation of 135 digits. Plast Reconstr Surg. 1996; 98 470-476
- 9 Hattori Y, Doi K, Ikeda K, Abe Y, Dhawan V. Significance of venous anastomosis in fingertip replantation. Plast Reconstr Surg. 2003; 111 1151-1158
- 10 Goldner R D, Stevanovic M V, Nunley J A, Urbaniak J R. Digital replantation at the level of the distal interphalangeal joint and the distal phalanx. J Hand Surg Am. 1989; 14 214-220
- 11 Tark K C, Kim Y W, Lee Y H, Lew J D. Replanation and revascularization of hands: Clinical analysis and functional results of 261 cases. J Hand Surg Am. 1989; 14 17-27
- 12 Cheng G L, Pan D D, Qu Z Y et al.. Digital replantation: A ten-year retrospective study. Chin Med J. 1991; 104 96-102
- 13 Strauch B, De Moura W D. Arterial system of the fingers. J Hand Surg Am. 1990; 15 148-154
- 14 Smith D O, Oura C, Kimura C, Toshimori K. The distal venous anatomy of the finger. J Hand Surg Am. 1991; 16 303-307
- 15 Moss S H, Schwartz K S, von Drasek-Ascher G, Ogden 2nd L L, Wheeler C S, Lister G D. Distal venous anatomy. J Hand Surg Am. 1985; 10 473-482
- 16 Matsuda M, Chikamatsu E, Shimizu Y. Correlation between number of anastomosed vessels and survival rate in finger replantation. J Reconstr Microsurg. 1993; 9 1-4
- 17 Lee B I, Chung H Y, Kim W K, Kim S W, Dhong E S. The effects of the number and ratio of repaired arteries and veins on the survival rate in digital replantation. Ann Plast Surg. 2000; 44 288-294
- 18 Han S K, Chung H S, Kim W K. The timing of neovascularization in fingertip replantation by external bleeding. Plast Reconstr Surg. 2002; 110 1042-1046
Hyun Oun HahnM.D. Ph.D.
Hahn Hyun Oun Hand Clinic Center
586-2 ChangSung Building, ShinDaeBang-dong, Seoul 156-852, Korea