Abstract
Traumatic finger amputation is a severe injury, and several problems may remain after successful replantation. We applied free tissue transfer to resolve these problems in four cases. All patients were male, and the patients ranged from 8 to 34 years in age. A free scapular flap and thoracodorsal perforator flap were applied for reconstruction of the first web and palmar contracture combined with tendon grafts. Second toe transfer and second toe joint transfer were used in finger reconstruction. These secondary procedures were performed more than 3 months after the initial injury. Recipient vessels were taken proximal to the injured sites. All free tissue flaps survived. Free skin flap transfer for widening of the first web space improved grip function of the hand. Toe transfer ameliorated the esthetic appearance of the hand by restoring the number of fingers. However, it was difficult to improve the range of motion of the injured fingers. Meticulous surgical planning and rehabilitation programs are essential to obtain good outcomes, because replanted fingers have already been subjected to severe contracture caused by scar formation and tendon adhesion.
