A technique for replantation of the finger tip

The finger-tip replantation technique reported here has evolved over 15 years. Indications for surgery include both strong patient desire and specialized use of the finger tip. Palmar flaps are elevated as full-thickness skin grafts to avoid injury to palmar veins. Arteries and palmar digital veins are repaired using an open-vessel technique. Postoperative care varies from immediate discharge with follow-up to inpatient care using surgical leeches or continuous bleeding as a method of drainage should venous congestion develop. The survival rate of 26 finger tips replanted using this technique between 1981 and 1987 was 69%. Two-point discrimination returned in 75% of patients, and 25% had two-point discrimination of less than 5 mm. The distal interphalangeal joint retained an average range of motion of 56 degrees. Appearance was excellent, and patient satisfaction was high.