Pelissier P, Elbaz M, Casoli V, Martin D, Baudet J
Service de Chirurgie Plastique, Chirurgie de la Main et Microchirurgie, Hôpital du Tondu, Bordeaux, France.
Ann Chir Plast Esthet. 1998 Apr;43(2):182-7; discussion 188.
Following replantation failure, fingertip reconstruction was performed as an emergency "reposition-flap" procedure in seven patients (eight fingers). This technique was intended for amputations distal to the DIP joint in long fingers, and IP joint in the thumb. Pulp was excised on the amputated segment, and the remaining bone and nail bed were reattached to the proximal stump with Kirschner wires. Pulp was reconstructed with a local advancement and sensitive flap. Trophicity and nail regrowth as well as mobility and strength were satisfactory in five cases. MRI examination showed revascularization of the distal bone fragment in four cases. This procedure is an alternative to amputation after replantation failure when patients do not accept finger shortening. The more distal the amputation, the better is the result.