Digital amputations and their reconstruction: reconstructive surgery of the fingers

Reconstructive surgery of the fingers has been greatly modified and improved by the introduction of microsurgery. Fifty-three cases, in the past five years, of hand mutilation due to an amputation and the reconstructive techniques used have been reviewed. In the majority of the secondary reconstructions, three fundamental methods have been combined: (1) medialisation of the digits, (2) prolongation of the digits from "nearby" transpositions (remainders of proximal fingers), and (3) transfers from foot to hand. Beginning with this analysis, a classification of the procedures according to the defect to be reconstructed can be developed. Finally, the results in relation to the procedures applied have been analysed and technical observations that derive from these are pointed out, both for the donor foot as well as for the reconstructed hand.