DECOMPRESSION AND DIVERTING EFFECTS OF VASCULAR ANASTOMOSIS BASED ON DIGITAL ARTERIAL ARCH BRANCH IN REPL ANTATION OF FREE FINGER-PULP_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHAILibing ¹ , LIUHongxia ² , LIUYuejiao ¹ , LULaijin ¹ ,  CUIJianli ¹

1. Department of Hand and Foot Surgery, the First Affiliated Hospital of Jilin University, Changchun Jilin, 130021, P. R. China;
2. Department of General Surgery, the First Affiliated Hospital of Xinxiang Medical College;

Corresponding author：

CUIJianli, Email: tsuijianli@126.com

Keywords：

Digital replantation; Finger-pulp; Venous reflux

DOI：

10.7507/1002-1892.20160043

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the decompression and diverting effects of vascular anastomosis based on the digital arterial arch branch in replantation of free finger-pulp in distal phalanges. Methods A retrospective analysis was performed on the clinical data of 12 patients (12 fingers) who underwent free finger-pulp replantation with anastomosis of proper palmar digital artery and the palmar digital artery arch branch in the distal end between December 2004 and March 2015. Of 12 cases, 9 were male and 3 were female, aged 15-39 years with an average of 32 years. The causes of injury included cutting injury in 4 cases, crush injury in 7 cases, and avulsion injury in 1 case. The thumb was involved in 2 cases, index finger in 4 cases, ring finger in 3 cases, middle finger in 1 case, and little finger in 2 cases. The free finger pulp ranged from 1.8 cm×1.5 cm to 2.8 cm×2.0 cm. The time from injury to operation ranged from 1.5 to 11.0 hours, with an average of 5.7 hours. No arterial arch or proper palmar digital arteriae anastomosis was excluded. Results Free finger-pulp survived in 11 cases after operation; venous crisis occurred in 1 case at 2 days after operation, and was cured after symptomatic treatment. Nine cases were followed up 6-18 months with an average of 10 months. The finger-pulp had good appearance, clear fingerprint, and soft texture. The two-point discrimination was 3.1-6.0 mm, with an average of 4.6 mm at 6 months after operation. The function of finger flexion and extension was normal. And according to upper extremity functional evaluation standard by hand surgery branch of Chinese Medical Association, the results were excellent in 7 cases, and good in 2 cases. Conclusion In the replantation of amputated pulp with insufficiency of venous blood outflow, the anastomosis of digital arterial arch branch in the distal end can decompress and shunt arterial blood, adjust blood inflow and outflow, and solve the problems of insufficient quantity of the vein and venous reflux disturbance.

Citation： CHAILibing, LIUHongxia, LIUYuejiao, LULaijin, CUIJianli. DECOMPRESSION AND DIVERTING EFFECTS OF VASCULAR ANASTOMOSIS BASED ON DIGITAL ARTERIAL ARCH BRANCH IN REPL ANTATION OF FREE FINGER-PULP. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(2): 211-214. doi: 10.7507/1002-1892.20160043 Copy

1.	田万成, 潘希贵, 卢全中, 等. 指尖离断分型与再植. 中国创伤骨科杂志, 2000, 2(3):197-198.
2.	江起庭, 江志伟, 杨丽娜. 指侧方静脉在指尖离断再植中的应用. 中国修复重建外科杂志, 2013, 27(2):251-252.
3.	Hattori Y, Doi K, Ikeda K, et al. Significance of venous anastomosis in fingertip replantation. Plast Reconstr Surg, 2003, 111(3):1151-1158.
4.	王泉, 牛洪峰, 肖春来, 等. 吻合静脉联合改良动静脉转流术治疗手指末节离断伤. 中国骨与关节损伤杂志, 2015, 30(9):996-997.
5.	潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3):130-135.
6.	Strauch B, de Moura W. Arterial system of the fingers. J Hand Surg (Am), 1990, 15(1):148-154.
7.	丁自海, 王昌德, 刘文宽, 等. 指尖的血管构筑. 解剖与临床, 1999, 4(2):65-67.
8.	顾玉东, 王澍寰, 侍德. 手外科手术学. 2版. 上海:复旦大学出版社, 2010:726-771.
9.	吴克俭, 王富, 张建, 等. 指腹再植六例. 中华显微外科杂志, 2005, 28(2):102.
10.	Chen YC, Chan FC, Hsu CC, et al. Fingertip replantation without venous anastomosis. Ann Plast Surg, 2013, 70(3):284-288.
11.	王相, 张威凯, 毛根莲, 等. 吻合掌侧静脉且保留指甲的多指指尖离断再植. 中国修复重建外科杂志, 2014, 28(3):391-392.
12.	Kamei K, Sinokawa Y, Kishibe M. The venocutaneous fistula:a new technique for reducing venous congestion in replanted fingertips. Plast Reconstr Surg, 1997, 99(6):1771-1774.
13.	Koshima I, Yamashita S, Sugiyama N, et al. Successful delayed venous drainage in 16 consecutive distal phalangeal replantations. Plast Reconstr Surg, 2005, 115(1):149-154.
14.	Hsu CC, Lin YT, Moran SL, et al. Arterial and venous revascularization with bifurcation of a single central artery:a reliable strategy for Tamai Zone I replantation. Plast Reconstr Surg, 2010, 126(6):2043-2051.
15.	姚保兵, 胡亮, 尹成国, 等. 指动脉静脉化在手指末节离断再植的疗效分析. 中国临床解剖学杂志, 2012, 30(6):705-707.
16.	杨中华, 周必光, 彭正人, 等. 经骨髓腔静脉回流的指尖再植. 中华手外科杂志, 2002, 18(4):206-208.
17.	王群. 指动脉替代回流在静脉缺损的末节断指再植中的应用分析. 中华创伤骨科杂志, 2006, 8(6):583-584.
18.	宋溦, 黄东, 邱斌, 等. 缺乏可吻合静脉的末节断指再植的研究进展. 中国临床解剖学杂志, 2015, 33(1):111-112.
19.	Cheng GL, Pan DD, Yang ZX, et al. Replantation of digits amputated at or about the distal interphalangeal joint. Ann Plast Surg, 1985, 15(6):465-473.

1. 田万成, 潘希贵, 卢全中, 等. 指尖离断分型与再植. 中国创伤骨科杂志, 2000, 2(3):197-198.
2. 江起庭, 江志伟, 杨丽娜. 指侧方静脉在指尖离断再植中的应用. 中国修复重建外科杂志, 2013, 27(2):251-252.
3. Hattori Y, Doi K, Ikeda K, et al. Significance of venous anastomosis in fingertip replantation. Plast Reconstr Surg, 2003, 111(3):1151-1158.
4. 王泉, 牛洪峰, 肖春来, 等. 吻合静脉联合改良动静脉转流术治疗手指末节离断伤. 中国骨与关节损伤杂志, 2015, 30(9):996-997.
5. 潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3):130-135.
6. Strauch B, de Moura W. Arterial system of the fingers. J Hand Surg (Am), 1990, 15(1):148-154.
7. 丁自海, 王昌德, 刘文宽, 等. 指尖的血管构筑. 解剖与临床, 1999, 4(2):65-67.
8. 顾玉东, 王澍寰, 侍德. 手外科手术学. 2版. 上海:复旦大学出版社, 2010:726-771.
9. 吴克俭, 王富, 张建, 等. 指腹再植六例. 中华显微外科杂志, 2005, 28(2):102.
10. Chen YC, Chan FC, Hsu CC, et al. Fingertip replantation without venous anastomosis. Ann Plast Surg, 2013, 70(3):284-288.
11. 王相, 张威凯, 毛根莲, 等. 吻合掌侧静脉且保留指甲的多指指尖离断再植. 中国修复重建外科杂志, 2014, 28(3):391-392.
12. Kamei K, Sinokawa Y, Kishibe M. The venocutaneous fistula:a new technique for reducing venous congestion in replanted fingertips. Plast Reconstr Surg, 1997, 99(6):1771-1774.
13. Koshima I, Yamashita S, Sugiyama N, et al. Successful delayed venous drainage in 16 consecutive distal phalangeal replantations. Plast Reconstr Surg, 2005, 115(1):149-154.
14. Hsu CC, Lin YT, Moran SL, et al. Arterial and venous revascularization with bifurcation of a single central artery:a reliable strategy for Tamai Zone I replantation. Plast Reconstr Surg, 2010, 126(6):2043-2051.
15. 姚保兵, 胡亮, 尹成国, 等. 指动脉静脉化在手指末节离断再植的疗效分析. 中国临床解剖学杂志, 2012, 30(6):705-707.
16. 杨中华, 周必光, 彭正人, 等. 经骨髓腔静脉回流的指尖再植. 中华手外科杂志, 2002, 18(4):206-208.
17. 王群. 指动脉替代回流在静脉缺损的末节断指再植中的应用分析. 中华创伤骨科杂志, 2006, 8(6):583-584.
18. 宋溦, 黄东, 邱斌, 等. 缺乏可吻合静脉的末节断指再植的研究进展. 中国临床解剖学杂志, 2015, 33(1):111-112.
19. Cheng GL, Pan DD, Yang ZX, et al. Replantation of digits amputated at or about the distal interphalangeal joint. Ann Plast Surg, 1985, 15(6):465-473.

Chinese Journal of Reparative and Reconstructive Surgery

DECOMPRESSION AND DIVERTING EFFECTS OF VASCULAR ANASTOMOSIS BASED ON DIGITAL ARTERIAL ARCH BRANCH IN REPL ANTATION OF FREE FINGER-PULP

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