[Clinical study of phalange fractures treated by absorbable intramedullary nail in replantation of severed finger].
OBJECTIVE
To study the effect of internal fixation with absorbable intramedullary nail on the treatment of phalange fractures in replantation of severed finger.


METHODS
From September 2001 to October 2003, 28 cases with industrial severed finger (21 males and 7 females, with the age of 18-35 years) were replanted within 1-6 hours. The severed locations were index fingers in 11 cases, middle fingers in 8 cases, ring fingers in 6 cases, little fingers in 3 cases. All cases of phalange fractures were fixed by absorbable intramedullary nails of poly-DL-lactic acid (PDLLA) that combined with chitosan. Out of the 28 cases, 15 cases were with proximal phalange, 11 cases were with middle phalange, 2 cases were with distal phalange. The bone marrow cavity of the phalanges were dilated, then the intramedullary nail was inserted with suitable diameter and length to fix the fracture. Postoperatively resin bandage was applied for 3-4 weeks.


RESULTS
All the 28 patients survived the performance and postoperative follow-up ranged from 3 to 10 months (4 months in average). Rejection was observed in one case 3 weeks after operation, bone unions were obtained in other cases. According to the Chinese Medical Association's evaluation standard for replantation of amputated finger, 18 fingers resulted in excellence, 9 fingers in good function and 1 with unsatisfactory function. The excellent and good rate was 96.4%.


CONCLUSIONS
Internal fixation with absorbable intramedullary nail of PDLLA combined with chitosan proves to be effective in the replantation of severed finger.
Huang
Chaotong
C
Department of Microsurgery, Fangshuquan Hospital, Dongguan Guangdong 523945, PR China. myhCT@medmail.com.cn
Li
Jingkuang
J
Zhu
Jiakai
J
Xie
Guangzhong
G
Chen
Dongsheng
D
Li
Qingyu
Q
D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D048271:Chitosan; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D050278:Finger Phalanges / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D019344:Lactic Acid; D008297:Male; D011108:Polymers; D012092:Replantation; D016896:Treatment Outcome; D055815:Young Adult
D011108:Polymers; D019344:Lactic Acid; D048271:Chitosan