title: Leech therapy in nearly total amputation of fingers without vascular repair: a case report.
abstract: BACKGROUND
  In the absence of microvascular replantation or in crash injury cases in which obtaining an acceptable function is not possible, amputation of the injured finger seems to be the best treatment modality. Some studies recommended leech therapy for this kind of injury after vascular repair to decrease venous congestion.
  
  
  METHODS
  In this case report, the authors presented a case of leech therapy after near total amputation of the fingers. A 25-year-old patient was admitted following a sawing injury with crashed bundles of the third, fourth and fifth fingers. Microvascular surgery was not performed because of crush injury.
  
  
  CONCLUSIONS
  After a simple repair and pin fixation, the patient was treated using leech therapy. The result was satisfactory. The third and fourth fingers were salvaged. It seems that in cases where a small part of the skin is still attached to the amputated part, even with complete crash of both bundles, leech therapy can help salvage the amputated fingers.
authors.affiliation: Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: TarazJamshidi
authors.affiliation: Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Farshid
authors.initials: F
authors.lastname: Bagheri
authors.affiliation: Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Masud
authors.initials: M
authors.lastname: Mirkazemi
authors.affiliation: Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Amelfarzad
authors.affiliation: Department of Research and Education, Razavi Hospital, Mashhad, IR Iran.
authors.forename: Hami
authors.initials: H
authors.lastname: Ashraf
authors.affiliation: Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Azami
authors.affiliation: Faculty of Medicine, Mashhad Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, IR Iran.
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Peivandi
keywords: Amputation; Hyperemia; Leeches; Vascular System Injuries