DISTAL PHALANX MICROSURGICAL REPLANTATION

Replantation of a completely amputated part of the distal phalanx, whi ch has a very small vessel size, has been reported by several authors with a varying rate of success. Drainage through venous anastomosis is not always possible. In 12 completely amputated fingers, at the level of, or more distal to, the distal interphalangeal joint, we attempted microsurgical replantation with a successful outcome in ten cases. Se ven digits had one or two veins anastomosed. In five digits, an adequa te size vein was not found, and the drainage was accomplished with pro voked bleeding which was maintained for the 3 postoperative days at th e expense of blood transfusion. In all successful cases the patients r eturned to their occupation in a mean of 9 weeks with very good or exc ellent functional results. (C) 1994 Wiley-Liss, Inc.