Reconstruction of Digits Injured by Punch Press Machine

Hwang,  So Min; Lee,  Jong Seo; Kim,  Hyung Do; Jung,  Yong Hui; Kim,  Hong Il

doi:2013.18.4.155

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Arch Hand Microsurg > Volume 18(4); 2013 > Article

Original Article

Journal of the Korean Society for Surgery of the Hand 2013;18(4):155-160.
Published online December 30, 2013.
DOI: https://doi.org/10.12790/jkssh.2013.18.4.155

Reconstruction of Digits Injured by Punch Press Machine

So Min Hwang, Jong Seo Lee, Hyung Do Kim, Yong Hui Jung, Hong Il Kim

Hand and Microsurgery Center, Good Moonhwa Hospital, Busan, Korea. blueorange1009@hanmail.net

Received: 4 September 2013 • Revised: 15 November 2013 • Accepted: 3 December 2013

Abstract

Purpose
Digits injured by punch press machines show peculiar types with segmental loss of middle part of digits. Although the distal parts of finger survived, thr results is frequently unfavorable with respect to function and appearance after inappropriate reconstruction.

Methods
From August 2008 to February 2013, five digits injured by punch press machines in four patients were managed. Pinch strength, two-point discrimination and active range of motion were measured to evaluate finger function.

Results
Three digits with a preserved amputated segment underwent replantation. Partial necrosis occurred in one digit in which local flap was performed. Secondary tendon graft was performed in the other digits. Two digits without segment was reconstructed by arthrodesis after shortening the length. The patients were generally satisfied with function and appearance.

Conclusion
Reconstruction of digits injured by punch machines are technically difficult. Replantation is the best method in cases of preserved segment, while arthrodesis with shortening is appropriate in cases without segment.

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