Replantation of Portions of Four Fingers—Long-term Functional Results

We present a seven-year follow-up of a previously published case of 4-finger replantation in one hand. Replantation of the digits proved justified, yielding favorable results in sensory return, motor function, and appearance. We note that finger replantations distal to the proximal interphalangeal joint are associated with better functional results than those at more proximal levels. Impaired motion of the distal interphalangeal joint does not appreciably restrict the function of the hand, provided adequate range of active movement is preserved at the metacarpophalangeal and proximal interphalangeal joints. An uninjured proximal interphalangeal joint is critical in achieving favorable motor return after finer replantation. Technical excellence in digital nerve repair contributes to favorable sensory axonal regrowth. Digital replantation distal to the proximal interphalangeal joint may be viewed as primary microneurovascular reconstruction of a problem finger amputation stump. We believe, in the case of sharp amputation distal to an intact proximal interphalangeal joint, that single-digit replantation is indicated, given the likelihood of favorable functional and aesthetic results.