The Y-V-I principle for salvaging distal digit replantation

The replantation and revascularization of a distal finger following a crush injury or avulsion are difficult because of the shortness of the vessels after debridement. The success rate of the anastomoses may decrease when they are under tension. To address this, many maneuvers have been described, such as shortening the amputated part or proximal finger stump for tensionless closing, interposing a vein graft between the vessel ends, and vessel transfer from a neighboring finger. Regardless of which of these techniques is chosen, it is an additional drawback for the already traumatized hand or amputation stump. Y-V-I pedicle lengthening is a method for providing extra pedicle length. This article presents a pediatric patient with a traumatic partial amputation at the fourth distal interphalangeal joint in whom the finger was salvaged by achieving anastomoses using the Y-V-I pedicle-lengthening principle.