Natural history of digital replantation: a 12-year prospective study.

Abstract

The purpose of the study was to evaluate the fate of the digital arterial anastomoses, resting total digit blood flow, and cold-induced discomfort following digital replantation with two repaired arteries. The evaluation was done with a Doppler ultrasound of the anastomoses, temperature recording from the finger pulp at room temperature, and a questionnaire regarding the patient's impression of cold-induced discomfort. At the 2-year follow-up all anastomoses were patent, but in two of the six patients one anastomosis was occluded at the 12-year follow-up. The replanted digits generally showed lower skin temperatures compared with controls at the 2-year follow-up but these had normalized 10 years later, even in digits with one of the two repaired arteries occluded. The number of patients with severe cold-induced discomfort was unchanged during the observation period. The digital flow continues to increase after the first 2 years after replantation and may reach normal levels at room temperature; however, cold-induced discomfort is not normalized. Total blood flow improvement is not affected by late arterial occlusion.