During past 7 years from 1988 to 1994, microsurgical replantations have been performed for 37 complete finger tip amputations in 34 patients. These fingers were classified according to Allen's criteria (type III-15, type IV-22). 5 of the 37 fingers resulted in failure, six fingers had partial necrosis, however the remaining 26 had no necrosis. Survival rate was 100% in clean cut amputation, 90% in blunt amputation, 60% in crush amputation and 50% in avulsion amputation.
Postoperative results were evaluated in 25 fingers of 22 patients with a follow-up period more than 1 year. The paresthesia of the finger tip was present in 9 finger tips and cold intolerance was present in 8 finger tips. The average static 2 point discrimination test was 5.8mm, renging from 2-10mm. Nail deformity was seen in 3 finger tips and mallet deformity in 3 fingers. 8 finger tips had mild atrophy. Functional results by Tamai's criteria vudged 21 patients to be excellent and 1 patient good. Almost all patients wete satisfied with the results.
From this study, we concluded that replantation with microvascular anastomosis is the first choice for finger tip amputation.
