Type of injury and number of anastomosed vessels: impact on digital replantation.

Abstract

A retrospective study of 130 digital replantations was analyzed to identify factors influencing success rates. At the amputation between the middle phalanx and distal interphalangeal joint, it was found that type of injury and number of anastomosed vessels and veins were the most important factors. Amputations caused by mechanical crush reduced the number of available vessels for anastomoses. Having an anastomosed artery without any anastomosed vein significantly reduced the success rate compared with cases of amputation by knife or sawing machine, where at least an artery and a vein could be anastomosed. In replantation at the distal phalanx, only one anastomosed artery without any anastomosed vein could also result in high success. And in most cases of amputation between the proximal phalanx and proximal interphalangeal joint, there was no difficulty in finding at least an artery and a vein. Knowledge of anatomical transitions is therefore important for surgeons.