Spare part composite graft for traumatic fingertip amputation: a case series.

Abstract

Previously, traumatic amputations particularly those caused by blunt trauma were treated with proper subsequent amputations. However, this led to postoperative pain, disturbances in multiple functions of the extremities including sensory capability and fine motor dexterity. We presented five cases of traumatic fingertip amputation treated with spare part composite graft. In spare part composite grafting, both the amputated finger and the distal end (stump) of injured finger was fixated directly after skeletonization of the amputated finger. The blood supply initially depends on diffusion, and later with neovascularization. The regional flap for the soft tissue defect closure was then applied to the composite graft. At the final follow-up of minimum a month, complete graft survival with favorable functional and aesthetic outcomes with minimal complications were observed. Four of the cases had preserved, normal sensory. The spare part composite graft and the use of regional flap for defect closure is an alternative option in selected fingertip amputation with satisfactory results.