ALTERNATIVE TECHNIQUES FOR RESTORATION OF BONY SEGMENTS IN DIGITAL REPLANTATION

We present our experience from 108 partially or totally amputated digi ts in 87 patients which were replanted or revascularized successfully by the Orthopaedic Microsurgical Team at the University of Ioannina Me dical School in Greece, during the period from 1978 to 1994. The major ity of the patients were men involved in occupational accidents. Bone shortening always preceded the osteosynthesis and the Vessel anastomos is, and most of the available methods for osteosynthesis were used, in cluding small plates, single lag screws, crossed Kirschner wires, a co mbination of intraosseus cerclage wires and Kirschner wires, and intra medullary Kirschner wires. Our findings suggest that the most appropri ate method for bone fixation in digital replantation is the insertion of one intramedullary Kirschner wire, supplemented by another wire whi ch is inserted at the end of the procedure. This technique was found s uperior for the following reasons: 1) it's simplicity and the speed of the technique reduced the ischemic time; (2) less bone exposure was r equired; (3) less skeletal mass was needed for fixation; and (4) prior to the insertion of the second Kirschner wire, rotation of the replan ted part was possible if it was necessary to re-align the vessels or t o correct any rotational deformity