Replantation of digits amputated at or distal to distal interphalangeal joint

Journal of the Korean Society for Surgery of the Hand 2000;5(1):83-90.
Published online January 1, 2000.

Joo Sung Kim, Keum Young Song

수지원위부 절단의 재접합술

김주성, 송금영

Abstract

Purpose
: With the amputation at or distal to the distal interphalangeal joint, the thought that microsurgical replantation can get the best result, is generalized. We report our experience with the review of related articles. Materials and Methods : From July 1993 to July 1999, 274 digits of 218 patients with complete amputation at or distal to the distal interphalangeal joint, were attempted microsurgical replantation at Taegu Hyundae hospital. 73% of the patients was male and according to the age distribution, the third and fourth decade of life were 29% and 22%. The order of involved digits was index, middle, ring and little finger. Local crushing and guillotine type of amputation were dominant, and 109 cases were at zone I and 165 cases were at zone II according to the Yamano classification. With microsurgical vascular anastomosis pattern, in 73%(77 cases) of zone I, we anastomosed 1 artery, and in 78%(129 cases) of zone II, we anastomosed 1 artery and 1 vein. Results : The overall success rate was 79%(216 cases), and in zone I 73%(80 cases), in zone II 82%(136 cases). The replanted digits preserved satisfactory functional and cosmetical result with good digit length and nail. Conclusion : With the distal al amputation, despite of the difficulties microsurgical replantation get good satisfaction of patients. So microsurgical replantation is thought to be a good method of recontruction in distal al amputation.