Long-Term Fate of the Anastomosed Digital Artery after Successful Replantation

We have found that some replanted fingers were survived not by the supply of blood from anastomosed arteries but by the neovascularization of the soft tissue. Therefore, we checked if the anastomosed arteries will consistently be in patency and the average time it takes for anastomosed digital arteries to be occluded after replantations. We surveyed a total of 75 fingers to evaluate patency of the anastomosed arteries using Doppler. We performed angiogram for 15 fingers on the average of 30th day after replantations. We further analyzed the causes, types, levels, vein graft, and the number of venorrhaphies. We couldn't find, using the Doppler, the pulsations of the anastomosed arteries on 28 fingers but could find the occlusions of anastomosed arteries from 10 fingers on angiogram. In case of 43 percent in crushing and 8 percent in clean cut, pulsation was not heard in the Doppler (p<0.05). The unheard ratios is 51 percent in distal phalanx, 8 percent in mid-phalanx and 37 percent in proximal phalanx, respectively. Twenty-eight fingers (37%) out of 75 didn't show consistent patency on the average of 15 days after operation. The results show that the causes and levels of amputation were factors affecting the patency of arteries.

Retrograde replantation method for amputated hallux / 临床外科杂志

Objective To investigate the characteristics and the effect of severed hallux replantation.Methods Eighteen completely severed halluces had been replanted since 1991.Injuried foot were kept in extending at 90?-120? position.The sequence of hallux replantation was opposed to the classical order and was so called"the retrograde replantating means(RRM)".The order of RRM was defined as follows: skin of toe abdomen→subcutaneous vein of toe abdomen→inhered toe nerve→inhered toe artery→flexor toe tendon→toe fixation by a single K-needle→extendor toe tendon→artery in the back of toe→subcutaneous vein of toe back→skin of bilateral and back.Results Sixteen of eighteen halluces survived replantation(89.9%).The total flexion degree in replanted halluces was 25?～70?.The appearance of amputated toes restored well.The two-point discrimination was 10～16 mm.Eleven cases walked as entirely usually in gait, and seven cases had basic normal gait.Conclusions Replantation of severed halluces could alleviate wound and remnant greatly.The recovery of foot function and aspect of replanted toes was satisfactory.The RRM gradation showed a distinctive advantage that there was no requiring for injuried foot be moved during operation.