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Advances in digital replantation

M Merle1, G Dautel

  • 1Service du Chirurgie Plastique et Reconstructive de l'appareil locomoteur, Centre Hospitalo-Universitaire de Nancy, Hopital Jeanne d'Aro, France.

Clinics in Plastic Surgery
|January 1, 1997
PubMed
Summary

Digital replantation success depends on injury type and location. Distal replantations offer the best outcomes, even for cosmetic reasons, and are technically simple for trauma teams.

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Area of Science:

  • Microsurgery
  • Trauma Surgery
  • Orthopedic Surgery

Background:

  • Advancements in revascularization and skin grafting enhance digital replantation possibilities.
  • Replantation decisions must consider injury severity, patient needs, and functional outcomes.

Purpose of the Study:

  • To evaluate the indications and outcomes of digital replantation surgery.
  • To emphasize the value of distal digital replantations and inform trauma teams.

Main Methods:

  • Review of technical considerations in digital replantation.
  • Assessment of factors influencing functional recovery, including tendon repair and resensitization.

Main Results:

  • Distal and very distal digital replantations yield the best functional and cosmetic results.
  • Replantation is technically straightforward for vessels as small as 0.5 mm in diameter.
  • Patient satisfaction can be achieved even with stiff or insensitive digits for cosmetic reasons.

Conclusions:

  • Digital replantation is indicated for multiple digital lesions and thumb avulsions to restore pinch capacity.
  • Proximal amputations with severe crush injuries may not warrant replantation if function is paramount.
  • Surgeons must carefully weigh indications, patient expectations, and functional outcomes in digital replantation decisions.

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