MICROSURGICAL TREATMENT OF RING AVULSION INJURIES

Fourteen patients with ring avulsion injuries were treated at the Univ ersity of Ioannina from 1982 to 1991. One patient was classified as Ur baniak class II, and microsurgical repair produced good functional res ults. The remaining 13 patients had class III injuries. Six of these p atients had class IIIa injuries, defined as skin avulsions at the leve l of the proximal phalanx, amputation at the distal interphalangeal jo int with an intact flexor digitorum superficialis. Replantation was su ccessful in four patients. Seven patients had class IIIb injuries, def ined as skin avulsion and complete amputation at the level of the prox imal phalanx, with severance of both flexor tendons. Replantation was successful in four patients, with compromised functional results in tw o. Primary surgical repair is the treatment of choice for class II and IIIa injuries which usually have rewarding results. Although there ma y be some functional compromise following replantation in class IIIb i njuries in adults, we suggest that microsurgical replantation should a lso be attempted after the prognosis is clearly explained to the patie nt. (C) 1994 Wiley-Liss, Inc.