Routine Surgical Procedures for the Replantation of Amputated Fingers

Replantation of amputated finger is a detailed and difficult project, requiring surgeons to perform the operation all through the course under the surgical microscope. Besides basic knowledge of orthopedics, vascular surgery, plastic surgery, it is necessary to being proficient in microsurgery technology operation, to achieve stable, accurate, skillful operating skills. According to the general principles, the order of replantation and the specific circumstances, flexible control and temporary adjustment of the surgical plan is needed to ensure that every step of the operation is correct. There are two orders of replantation of amputated fingers. One is antegrade replantation, using by most scholars conventionally, that debridement—skeletal fixation—repair of the flexor and extensor tendon—dorsal vein anastomosis-dorsal skin suture—inherent artery anastomosis—nerve anastomosis-palmar skin suture. The other one is retrograde replantation: debridement-palmar skin suture—finger nerve anastomosis—inherent arteries anastomosis—flexor tendon suture- skeletal fixation—extensor tendon suture—dorsal vein anastomosis-dorsal skin suture. The latter has the advantage of not having to turn over the hands during the surgical procedure, especially for replantation of thumb amputation, and severed fingers in children. Avoiding to pull and sprain the anastomosed blood vessels and nerves when a fracture is fixed. The specific operation are as follows (Fig. 7.1).