Fingertip replantation at the SubzoneⅡlevel has become more feasible with advances in microsurgical techniques. However, this replantation remains technically demanding due to the narrow operative field, complexity of vessel dissection, and risk of thrombosis when injured arteries are inadequately debrided. We report three cases of complete SubzoneⅡfingertip amputations treated with arterial anastomosis using interpositional vein grafts, without venous or nerve repair. In each case, the injured artery was thoroughly trimmed, and a vein graft harvested from the palmar wrist or thenar region was used to allow tension-free, precise anastomosis. All replanted fingertips survived without signs of venous congestion. Only one case showed partial superficial necrosis, which healed with conservative management. Postoperative sensory recovery, assessed via the Semmes Weinstein monofilament test, was near normal in all cases. Patient-reported outcomes, such as Q-DASH and Hand 20 scores, were favorable. These findings suggest that vein grafting is a useful technique for extending the indications of fingertip replantation in SubzoneⅡinjuries, enabling flexible vessel alignment and reliable arterial reconstruction.
