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Case Reports
. 2020 Mar 11;15(1):104.
doi: 10.1186/s13018-020-01621-w.

Mangled finger salvage using cross-finger revascularization

Song Chen  1 , Gen Wen  1 , Liang Cheng  2 , Yimin Chai  3
Affiliations
Case Reports

Mangled finger salvage using cross-finger revascularization

Song Chen et al. J Orthop Surg Res. .

Abstract

Background: Mangled finger with impaired arteria digitalis communis remains to be a challenge for replantation surgery due to the limited amount of tissue to work with.

Methods: Out of 554 hands with total finger amputations treated by replantation of finger/fingers from July 2012 to June 2018, there were 7 cases of damaged arteria digitalis communis, all of which were replanted by anastomosing distal adjacent radial/ulnar digital artery to distal end of ulnar/radial digital artery of amputation finger, and 2 veins were anastomosed for each finger. A skin pedicle was made by suturing both dorsal and palmar skin of adjacent fingers, and detachment was performed 4 weeks postoperatively.

Results: The survival rate was 100%. Mean total active motion was 191.4° (ranging from 170 to 220°). Mean 2-point discrimination was 8 mm static (ranging from 6 to 11 mm), and mean grip strength was 35.3 kg (range, 29 to 40 kg).

Conclusions: Based on our experience, cross-finger revascularization is an effective and safe alternative for mangled finger salvage when arteria digitalis communis is damaged, and good functional prognosis can be expected.

Keywords: Cross-finger revascularization; Microsurgery; Replantation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A drawn figure shows the cross-finger revascularization technique and the direction of blood flow
Fig. 2
Fig. 2
Clinical and radiological examinations of her right hand. a, b Shows a degloving injury in her right hand with PIP joint dislocation of the patient’s index and middle fingers. c Shows the radiological examination of her right hand
Fig. 3
Fig. 3
The cross-finger revascularization technique for mangled finger salvage. a Shows the degloving skin of her thumb and the dorsal surface of her hand was sutured in situ. b Shows the distal radial digital artery of the middle finger was anastomosed to the distal stump of the ulnar digital artery of the index finger. c Shows a skin pedicle was made by suturing the dorsal skin of the middle finger to the palmar skin of the index finger
Fig. 4
Fig. 4
The appearance and function of the index and middle fingers were satisfactory
See this image and copyright information in PMC

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