Salvage of an avulsion amputated thumb at the interphalangeal joint level using afferent arteriovenous shunting.
Replantation of digits following avulsion amputation is a challenge due to the severity of damage to the digital vessels. When the digital vessels are absent or severely injured, standard artery-to-artery or vein-to-vein anastomoses may be impossible and arteriovenous shunting can be used as a salvage procedure for arterial inflow or venous drainage. Previous cases of successful replantation of avulsed digits that were reperfused using afferent arteriovenous shunting reported small segments of tissues only, usually at the level of the distal phalangeal joint or distal to it. Our case demonstrates that afferent arteriovenous shunting can also provide adequate perfusion to a large piece of tissue in the thumb even when the amputation level is at the interphalangeal joint.
Chen
Kuang-Te
KT
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Kwei-Shan, Taoyuan 333, Taiwan, ROC.
Chen
Yi-Chieh
YC
Mardini
Samir
S
Wei
Fu-Chan
FC
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D005384:Finger Joint / Q000601:surgery; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D012092:Replantation / Q000379:methods*; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries* / Q000601:surgery