Objective: We have experienced the replantation of 730 digits ( 558 cases ) at our hospital over the past thirty years. Of these cases, 29 amputations ( 23 cases ) were caused by ropes. The aim of this study was to assess the mechanism of digital amputation by ropes.
Methods and Results: This study design was a retrospective analysis. All cases had undergone replantation by microvascular anastomoses. The success rate was 65.5% ( 19/29 ) , which was much lower than that of the other digital amputation cases ( 83.0% ) during the same period. Cases of amputation caused by a cattle-leading rope presented particularly poor results, even though 5 of 7 digits were replanted with vein grafts.
Conclusion: Both crushing and avulsion forces can be involved in rope injury. We speculate that severe digital vascular damage may occur even though the skin remains intact. Therefore, we have to differentiate damaged vessels from normal tissue, and vascular repair with a vein graft is clearly essential for successful engraftment.
