Primary vein grafting in treatment of ring avulsion injuries: a 5-year prospective study.
Out of 262 hands with total finger amputations treated by replantation of finger/fingers from January 2001 until January 2006, there were only 6 cases of type III ring avulsion injuries, all of which were replanted. Radical resection of the damaged part of the artery with primary vein grafting was used in each case; only 1 artery and 2 veins were anastomosed for each finger. The survival rate was 100%. Mean total active motion was 195 degrees (ranging from 175 degrees to 220 degrees ). Mean 2-point discrimination was 8.6 mm static (ranging from 4 to 11 mm) and 6.2 mm moving (ranging from 3 to 9 mm), and mean grip strength was 37.4 kg. We believe that liberal resection of the "zone of contusion" of vessels and primary vein grafting for arterial repair can improve the overall survival rate of replantation in type III ring avulsion injuries, and replantation can be attempted in majority of the cases; good hand function can be expected.
Clinic of Plastic and Aesthetic Surgery, St. Anne's University Hospital Brno, Berkova 34, 61200 Brno, Czech Republic. petr.hyza@fnusa.cz
Petr
P
Hyza
Jiri
J
Vesely
Lubos
L
Drazan
Igor
I
Stupka
Raul
R
Ranno
Fabio
F
Castagnetti
D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012092:Replantation; D013997:Time Factors; D014680:Veins / Q000637:transplantation*