Arterial and Venous Reconstruction of Finger Avulsion Amputation in Tamai ZoneⅢandⅣExcluding the Thumb

Abstract

　We investigated arterial and venous reconstruction for finger avulsion amputations in Tamai zonesⅢandⅣ, excluding the thumb. The study focused on the number of arteries and veins reconstructed and the necessity of vein grafts. We successfully replanted 22 fingers in 19 patients, comprising 16 males and three females, with a mean age of 50.1 years (range: 1-73 years) . The cases included seven complete amputations and 15 incomplete amputations. For revascularization of complete amputations, we performed A1V1 (four fingers) , A2V1 (two fingers) , and A1V2 (one finger) . We used vein grafts to arteries in three of seven complete amputations. For revascularization of incomplete amputations, we performed A1V1 (12 fingers) , A2V1 (two fingers) , and A1V2 (one finger) . Vein grafts to arteries were required in 9 of 15 incomplete amputations, and vein grafts to veins in 8 of 15 fingers. Our findings suggest that for successful replantation, a single artery and a single vein are sufficient for reconstruction. Vein grafts should be performed to obtain a high success rate if there is even a slight intimal injury to the arteries.