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Artery-only fingertip replantations using a controlled nailbed bleeding protocol
H Yener Erken1, Semih Takka, Ibrahim Akmaz
1Department of Orthopaedic Surgery, Anadolu Medical Center, Kocaeli, Turkey; Department of Orthopaedic Surgery, Academic Hospital, Istanbul, Turkey.
The Journal of Hand Surgery
|November 12, 2013
Summary
Fingertip replantations using an artery-only technique achieved an 88% success rate without vein or nerve repair. This method also resulted in adequate sensory recovery within two years.
Area of Science:
- Microsurgery
- Reconstructive Surgery
- Hand Surgery
Background:
- Fingertip replantation is a complex procedure.
- Traditional methods often involve vein and nerve repair.
- The artery-only technique offers a potentially simpler alternative.
Purpose of the Study:
- To evaluate the efficacy of an artery-only technique for fingertip replantation.
- To assess the treatment protocol and 2-year follow-up results.
- To determine the success rate and functional recovery without vein or nerve repair.
Main Methods:
- Retrospective review of 24 fingertip replantations (2005-2011).
- Inclusion criteria: complete amputation distal to the distal interphalangeal joint or interphalangeal joint of the thumb.
- Standardized protocol: nail removal, intraoperative heparin, postoperative nailbed stimulation, and medical management.
Main Results:
- Successful replantation in 21 out of 24 cases (88%).
- Mean hospital stay of 7 days.
- 15 of 22 patients required blood transfusion (average 1.2 units).
Conclusions:
- The artery-only technique successfully reconstructs circulation for fingertip replantations.
- High success rates are achievable without venous anastomosis.
- Adequate sensory recovery occurred by 2-year follow-up, even without nerve repair.
