Distal digital replantation with a venous drainage through medullary cavit / 中华骨科杂志

ABSTRACT

Objective To introduce a method of distal digital replantation with a venous drainage through medullary cavity.Methods Normal saline mixed with methylene b lue were perfused into digital arteries in 5fresh finger specimens and medullary cavities in 10fresh finger specimens.Then microanatomic al observation of vessels was performe d in the specimens.From April 1999to June 2000,15severed fingers in14cases were replanted with a venous drainage through medullary cavity.Medullary cavities of the distal and middle phalanx were drilled and made unobstructed after the distal joint of the finger was removed.The bones were fixed using only a single straig ht Kirschner wire in each finger.One or two digital arteries or the branch es of the terminal arteries were anasto mosed and two digital nerves sutured in each finger.Results Mi-croanatomical observation showed t hat a venous drainage through medullary cavity was dominating without su-perficial venous drainage and the di gital medullary cavity closely connected with the profunda digital vein s and the superficial digital veins by the venous system of the bone.All replan ted fingers survived in 14cases.The average postoperative follow-up wa s 7.8months,ranging from 6to 10mont hs.Nearly normal appearance and satisfactory sensation of the dista l phalanx were obtained with 2-PD of 5-9mm.Conclusion Distal digital replantation with a venous d rainage through medullary cavity is a new method.It has following advan-tagessimple and reliable operatio n,high survival rate and enlarged in dication of distal digital replanta tion.[