Alternative to Vein Grafts for Arterial Repair in Avulsion Amputations of Thumb: Case Series.

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.