Finger-level avulsion-type injuries

Fifty-nine avulsed fingers were managed between May 1986-December 2004. Of 59 cases, 39 (66%) were treated with microsurgical techniques, and the remaining 20 cases (34%) were treated in the conventional manner. Follow-up time varied between 9-18 years. All cases were classified according to the Kay-Wolff classification. Replantation was done in 26 fingers, and revascularization in 13 fingers. The survival rate was 100% in the revascularization cases, and 80.7% in the replantation cases. The total active range of motion was more than 90 degrees in the interphalangeal joints in 48% of cases, and sensory recovery was good in 38% of cases (between 4-10 mm, static two-point discrimination test). Although the data show that avulsion injuries can be treated successfully by microsurgical techniques, functional results are not as successful. However, the decision for surgery at times is determined by nonmedical factors such as the patient's age, occupation, economic situation, and level of motivation.