Distal phalanx microsurgical replantation.

Replantation of a completely amputated part of the distal phalanx, which has a very small vessel size, has been reported by several authors with a varying rate of success. Drainage through venous anastomosis is not always possible. In 12 completely amputated fingers, at the level of, or more distal to, the distal interphalangeal joint, we attempted microsurgical replantation with a successful outcome in ten cases. Seven digits had one or two veins anastomosed. In five digits, an adequate size vein was not found, and the drainage was accomplished with provoked bleeding which was maintained for the 3 postoperative days at the expense of blood transfusion. In all successful cases the patients returned to their occupation in a mean of 9 weeks with very good or excellent functional results.