Fingertip replantation - obvious or debatable choice. Our experience

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• 作者：Emanuele Pamelin¹ ; ^{epamelin@tiscali.it" class="auth_mail" title="E-mail the corresponding author} ; Carlo Rossello² ; Andrea Zoccolan² ; Serena Savaia²
• 刊名：Chirurgie de la main
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：34
• 期：6
• 页码：385
• 全文大小：220 K

文摘

Fingertip injuries are one of the most frequent traumatic injury of the hand. Today fingertip replantation is an established surgical procedure but it is still a controversial surgical indication.

Patients and methods

From July 2007 to October 2014 17 patients (12 males, 5 females mean age 40.8) with fingertip amputation underwent to replantation surgery in our department. We classified fingertip amputation levels according to Ishikawa's classification.

Results

Eleven of the 17 fingertip replantations were successful. Four cases after venous stasis and two cases after arterial failure have been regularized. Patients were discharged 8 days after surgery (mean time). Active range of motion (ROM) at proximal interphalangeal joint (PIP) joint was 70°–90° (mean 82°) and for thumb reconstructions, Kapandji test was from 7 to 9 score. The Weber test was from 8 to 13 mm.

Discussion

Fingertip replantation represents a complex technical procedure for expert surgeons. Distal replantation is the most elegant and aesthetically satisfactory technique of tip reconstruction, superior to other alternative methods. However, surgical indications must to be personalized for each patient.