Twenty-five cases of avulsive amputation of the thumb are reported, Tw
enty-one of the 25 cases were categorized as Grade I avulsions (little
or no skin defect) and four were categorized as Grade II avulsions co
mplicated by a large skin defect. Three different replantation techniq
ues were used and compared: (1) direct vessel anastomosis, (2) arteria
l anastomosis between the superficial branch of the radial artery and
distal end of the thumb, and (3) arterial anastomosis after artery tra
nsfer from other digits. The authors concluded that direct vessel anas
tomosis was not the preferred method and that technique 2 could be use
d in any case but was especially suited to Grade II reconstructions. T
echnique 3 is mainly used in Grade I avulsions. (C) 1996 Wiley-Liss, I
nc.