Replantation of fingertips

Area of Science:

• Reconstructive Surgery
• Microsurgery
• Trauma Surgery

Background:

• Fingertip replantation is a complex procedure aiming to restore function and appearance.
• Success rates can vary significantly based on the zone of injury and the nature of the amputation.
• Understanding factors influencing outcomes is crucial for patient selection and surgical planning.

Observation:

• A retrospective analysis of 207 fingertip replantations (1976-1990) in 188 patients (133 male, 55 female, ages 14 months-80 years).
• Injuries were categorized into Zone 1 (131 cases) and Zone 2 (76 cases).
• Follow-up periods ranged from a minimum of 6 months.

Findings:

• Zone 1 replantations demonstrated varying survival rates based on injury type: 100% for clean-cut, 95% for blunt-cut, 64.3% for crush, and 65.5% for avulsion.
• Zone 2 amputations yielded satisfactory results in terms of both survival and function.
• All clean-cut and blunt-cut Zone 1 amputations achieved satisfactory outcomes.

Implications:

• Clean-cut and blunt-cut fingertip injuries, particularly in Zone 1, are highly amenable to successful replantation.
• Crush and avulsion injuries present greater challenges for fingertip replantation, necessitating careful consideration of surgical approach and patient expectations.
• These findings support the continued use of replantation for specific fingertip injuries, guiding surgical decision-making.