Finger Replantation with the Use of the Palmar Plexus Salvage Approach for Venous Drainage

Abstract

The replantation of an amputated fingertip is difficult, because a suitable vein is rarely available. Fingertip replantation using the palmar plexus salvage procedure for venous drainage was reported by Tanabe et al. in 2006. This is an alternative salvage procedure for fingertip replantation in cases with no suitable vein. We used this procedure for 6 distal phalangeal replantations in 4 patients with venous congestion between October 2010 and March 2012. According to the Ishikawa classification, the amputation levels were subzone 2 in 2 cases, subzone 3 in 3 cases, and subzone 4 in 1 case. Of the 6 replanted fingertips, 5 survived, and 1 with amputation at subzone 4 demonstrated partial necrosis. The palmar plexus salvage procedure is easy to perform and can provide satisfactory finger function. However, the use of this procedure may be limited for fingers amputated at the proximal part as we experienced a complication of partial necrosis in a case of amputation at subzone 4.