Research work · 2002

Fingertip replantation with a venous drainage through medullary cavity

Zhengren Peng

Zhonghua shouwaike zazhi

Abstract

Objective To report treatment outcome of fingertip replantation with a venous drainage through medullary cavity. Methods Twenty fresh finger specimens were involved. The digital arteries ( 10 fingers ) and medullary cavity at the distal phalange ( 10 fingers ) were perfused with normal saline mixed with methylene blue. Then the drainage was observed. Microanatomical observation was performed in perfusion group of medullary cavity. The amputated fingertips in 8 cases (9 lesions) were replanted with a venous drainage through medullary cavity from April 2000 to April 2002. Medullary cavities of the distal and proximal fragment in the distal phalanx were reamed. One or two digital arteries/the branches of the terminal arter arc were anastomosed and two digital nerves sutured in each finger after bone fixation.Results The perfusion experiments and microanatomical observation showed that there was a drainage through medullary cavity without hypodermic venous drainage and medullary cavity was closely connected with the hypodermic digital veins by the venous system of the bone. All 9 replanted fingertips without an anastomosed vein survived with a venous drainage through medullary cavity. They were followed up for 4 to 12 months. Near normal appearance and satisfactory sensation of the distal phalanx were obtained with 2-PD of 4～8 mm except nail loss at 1 case. Conclusions A venous drainage through medullary cavity was a practical method to establish venous drainage of fingertip at the early period of fingertip replantation.