We investigated %TAM, grip strength, perception, and DASH (JSSH Version) in patients who underwent replantation following complete finger amputation, categorized according to the Tamai Zone classification. In Zone I and II, the postoperative outcomes were generally favorable; however, instances of poor sensory recovery were observed, suggesting that detailed therapy, including sensory re-education, may be required. In Zone III, the range of motion of the DIP joint may decrease. Therefore, it is important to focus on obtaining satisfactory range of motion in the PIP joint. In Zone IV, early postoperative emphasis should be on achieving finger extension range of motion, so that only flexor tendon tenolysis is necessary as a second-stage procedure. Recently, patients have diverse life backgrounds; thus, it is important to set individual goals, such as specific acquisition angles for each finger, and appropriate treatment strategies.

  The free vascularized bone graft from the medial femoral condyle, first reported by Sakai et al. in 1991, was initially used as a periosteal bone graft for recalcitrant nonunion of the upper limb but was later reported to be useful for scaphoid nonunion. It is now widely used for various types of nonunion and avascular necrosis. Recently, a study reported that the cartilage morphology of the medial femoral trochlea resembles the proximal articular surface of the scaphoid and can be raised as a vascularized osteochondral graft. We have actively applied medial femoral condyle bone grafting to various cases of nonunion, including avascular necrosis of the scaphoid, since 2014, and performed cartilage reconstruction of the proximal part of the scaphoid and metacarpal head reconstruction by osteochondral grafting from the medial femoral trochlea since 2019. Herein, we report the key points and risks in the elevation of the vascularized bone and osteochondral graft from the medial femoral epicondyle and trochlea, and the characteristics of vascular anatomy of the DGA.

  【Introduction】Most of our residents aim to use microsurgery to perform future reconstructive surgical procedures. Therefore, we have been actively promoting opportunities for our residents to perform microsurgical procedures in parallel with their general plastic surgery training since the beginning of their training.　
  【Methods】We conducted a retrospective review of cases involving microvascular anastomosis (in both breast and head and neck reconstructions) and lymphaticovenular anastomosis performed by two residents in the University of Toyama Plastic Surgery Training Program during their first year. We analyzed the type of surgery, number of anastomoses, flap circulation inhibition time, intraoperative reanastomosis, and postoperative course including complications.　
  【Results】The average number of total microvascular anastomoses performed by each resident was 26 for breast and head and neck reconstructive surgery, and the average number of total lymphaticovenular anastomoses was 46.5.　
  【Conclusion】Our study highlights the microsurgical training experiences of first-year residents at our hospital. In actual clinical practice, residents successfully performed microsurgery without apparent major problems. The presence of an experienced supervisor was deemed essential for maintaining surgical results and improving the skills of the residents.