DIGIT REPLANTATION IN INFANTS AND YOUNG-CHILDREN - DETERMINANTS OF SURVIVAL

Thirty-three children under 34 months of age with 41 digits amputated over a 15-year period were reviewed. There were 3 primary amputations, 6 composite grafts, and 32 replantations. Twenty-one variables were e valuated for their influence on 4-week digit survival. The overall sur vival rate of 32 replanted digits was 69 percent. Favorable uncontroll able variables were clean-cut injury and body weight greater than 11 k g. Favorable controllable variables included more than one vein repair ed, bone shortening, interosseous bone fixation, and vein grafting of arteries or veins. Forty-one percent of children required a blood tran sfusion. Children with trauma to more than one digit were most likely to be transfused (p < 0.05). The combination of prompt digit reperfusi on after successful arterial repair and at least one successful venous anastomosis resulted in a 95 percent digit survival rate, significant ly higher than the 0 percent survival of digits lacking one or the oth er of these features(p < 0.01).