The primary use of venous grafts in thumb replantation

The authors describe modified thumb replantation technique. With this technique it is possible to avoid extensive mobilization of the digital arteries as well as incisions, particularly at the distal thumb phalanx, and therefore reduce further damage of the amputated part. Prior to the osteosynthesis a venous graft is harvested from the distal forearm or from the thenar area. Anastomosis between the venous graft and radial digital artery on the amputated part of the thumb is completed. Osteosynthesis of the bones with Kirchner wires follows. The venous graft is further anastomosed to the dorsal venous system of the stump. The arterial system is reconstructed with an anastomosis of the ulnar digital artery with a superficially positioned volar vein of the amputated part. The replantation technique described has proved effective in all cases when it was used.