Replantation for Finger Amputees under 12 Years Old

Abstract

  Traumatic finger amputations in children are relatively rare. In this study, we investigated replantation for traumatic finger amputation in children (aged < 12 years) at our hospital. This retrospective study included 11 consecutive children (12 fingers) who underwent finger replantation between 2006 and 2021. Of these, seven were boys and four were girls (mean age 6.1 years) , and mean follow-up duration was 24 months.　
  Mechanisms of injury included crush injuries (n = 8) , guillotine-induced injuries (n = 3) , and avulsion (n = 1) . Tamai’s classification zones I, II, III, IV, and V were observed (n = 1, 7, 2, 1, and 1 finger, respectively) . The overall survival rate was 50.0% (6 of 12 fingers) . We observed no signi-ficant differences in survival rate based on patient age, weight, the mechanism of injury, or Tamai’s classification. Replantation failure was secondary to arterial insufficiency (n = 3) , venous congestion (n = 1) , and unknown causes (n = 2) in six fingers. Artery-only replantation was performed (n = 9) . The external bleeding method was used (n = 8) . Salvage surgery for replantation failure was performed in four fingers using palmar pocket method, thenar flap, reverse island flap, and revision amputation.