title: Results of replantation of 33 ring avulsion amputations.
abstract: OBJECTIVE
  Despite microsurgical advances, it is still difficult to achieve satisfactory functional results in cases of replantations following complete ring avulsion amputations. Our aim is to report the experience we have collected since the early 1990s in the treatment of this type of injury.
  
  
  METHODS
  We replanted 33 fingers on 33 patients (age, 15-54 y) with complete ring avulsion amputation injuries. Twenty-eight amputations were distal to the insertion of the flexor digitorum superficialis, and 5 were complete degloving injuries with intact tendons. Vascular transpositions and vein grafts were used, and in all cases, only 1 of the digital nerves was repaired.
  
  
  RESULTS
  The 29 successful cases were tracked over an average follow-up of 89 months. The average total active motion of the reconstructed finger was 185°. Sensibility evaluated by static 2-point discrimination varied from 9 to 15 mm and by moving 2-point discrimination from 8 to 15 mm. Five patients complained of cold intolerance.
  
  
  CONCLUSIONS
  Resection of the avulsed digital artery and vein is the most crucial part of the procedure.Vessels reconstruction can be performed using various methods, but vessel transfers from the middle finger appear to be the most reliable solution. The outcome of the cases demonstrates that replantation should be attempted.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Hand Surgery and Microsurgery, University Hospital of Verona, Verona, Italy. roberto.adani@ospedaleuniverona.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Adani
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pataia
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarallo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Mugnai
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D001158:Arteries / Q000637:transplantation; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000294:innervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011826:Radial Nerve / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012092:Replantation / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult