Reconstruction of reflux in fingertip replantation by anastomosis of nailfold vein

Abstract

Objective To explore the clinical efficacy of anastomosis of nailfold vein in reconstruction of reflux of fingertip replantation. Methods From November 2016 to December 2017, 18 patients with 23 fingers of fingertip amputation in IshikawaⅡ area (from middle nail to nail root plane) were replanted. The parathyroidal longitudinal incision was used to explore and anastomose the nailfold vein to reconstruct the severed finger reflux, and the clinical efficacy was followed up. Results The follow-up period ranged from 8 to 15 months, with an average of 11.1 months. Twenty-one of the 23 fingers survived and two were necrotic. The survival rate was 91.3%. The protective sensation was restored in all surviving fingertips. The two-point discrimination was (8.8±2.4) mm. The active range of motion of distal interphalangeal joint was (49.8±12.3)°, which was 63.4% of the healthy side. The average blood perfusion volume of finger pulp was 89.3% of the healthy side. The complications included cicatricial contracture (5/23), nail deformity (7/23), nonunion (1/23), distal interphalangeal joint dysfunction (4/23), and cold intolerance (4/23). Conclusion The nailfold vein can provide reliable venous reflux in fingertip replantation and restore the good appearance and function of replanted fingertips. Key words: Finger injuries; Replantation; Vein; Microsurgery