ABSTRACT
The first reimplantation of a complete thumb amputation using microvascular anastomosis in a human was successfully conducted by Komatsu in 1968. Avulsion amputations of the thumb at the level of metacarpophalangeal joints pose a tedious task for direct arterial repair, even with adequate bone shortening. Owing to the short length of princeps pollicis from the deep arch, tight working space in the first web under microscope, and the associated intimal injuries, we advise transposing the radial indices artery in such cases which gives adequate length and noninjured artery for a tension-free repair. Using this method, surgeons can avoid the tedious task of vein grafts for arterial repair, reduce the operating time, and improve successful outcomes in thumb reimplantations.
ABSTRACT
Multiple methods have been described for treating unstable proximal and middle phalangeal fractures. Irrespective of using an open or closed technique of fixation, stiffness and extensor lag at the proximal/distal interphalangeal joint almost always occur. This issue can be avoided by allowing the patients to mobilize the fingers out of plaster or splint as early as possible from the day of surgery. We describe a technique of intramedullary percutaneous fixation of extra-articular proximal and middle phalanx fractures allowing immediate mobilization of fingers, concurrent stabilization with progressive healing and thus preventing such complications.
