Mangled finger salvage using cross-finger revascularization.

Abstract

Mangled finger with impaired arteria digitalis communis remains to be a challenge for replantation surgery due to the limited amount of tissue to work with. Out of 554 hands with total finger amputations treated by replantation of finger/fingers from July 2012 to June 2018, there were 7 cases of damaged arteria digitalis communis, all of which were replanted by anastomosing distal adjacent radial/ulnar digital artery to distal end of ulnar/radial digital artery of amputation finger, and 2 veins were anastomosed for each finger. A skin pedicle was made by suturing both dorsal and palmar skin of adjacent fingers, and detachment was performed 4 weeks postoperatively. The survival rate was 100%. Mean total active motion was 191.4° (ranging from 170 to 220°). Mean 2-point discrimination was 8 mm static (ranging from 6 to 11 mm), and mean grip strength was 35.3 kg (range, 29 to 40 kg). Based on our experience, cross-finger revascularization is an effective and safe alternative for mangled finger salvage when arteria digitalis communis is damaged, and good functional prognosis can be expected.