Finger replantations after ring avulsion amputations

Area of Science:

• Microsurgery
• Vascular Surgery
• Reconstructive Surgery

Background:

• Ring avulsion amputations present significant challenges for successful finger replantation.
• Assessing and restoring vascular integrity is critical for limb salvage in these complex injuries.

Purpose of the Study:

• To evaluate different vascular repair techniques in type IV ring finger replantations.
• To determine the functional outcomes and success rates of various arterial reconstruction methods.

Main Methods:

• Retrospective cross-sectional study of 37 patients undergoing finger replantation for type IV ring avulsion.
• Microscopic evaluation of arterial segments and assessment of proximal flow patterns.
• Comparison of digital artery transfer, vein graft interposition, and end-to-end anastomosis for arterial repair.

Main Results:

• Thirty-one of 37 (83.8%) replanted fingers survived.
• Failure was attributed to arterial insufficiency (4 cases) and venous insufficiency (2 cases).
• Digital artery transfer was the most frequently used method (21 fingers).

Conclusions:

• Radical resection of damaged vascular zones is essential for successful anastomosis.
• Choosing the appropriate vascular repair modality based on arterial flow is crucial for replantation success.
• Microsurgical techniques offer viable options for restoring vascular function in severe ring avulsion injuries.