Neural Regeneration Research ›› 2017, Vol. 12 ›› Issue (11): 1911-1917.doi: 10.4103/1673-5374.219053

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Evaluation of sensory function and recovery after replantation of fingertips at Zone I in children

Zhao-wei Zhu1, 2, Xiao-yan Zou3, Yong-jun Huang4, Jiang-hui Liu5, Xi-jun Huang2, Bo He2, Zeng-tao Wang6   

  1. 1 Department of Plastic Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
    2 Department of Orthopedics and Microsurgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
    3 Department of Neurology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
    4 Department of Orthopedics, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong Province, China
    5 Department of Emergency, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
    6 Department of Hand and Foot Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
  • Received:2017-09-15 Online:2017-11-15 Published:2017-11-15
  • Contact: Bo He, M.D., Ph.D.,hebodoc@gmail.com or hebodoc@aliyun.com.
  • Supported by:

    This study was supported by a grant from the Department of Health of Guangdong Province of China, No. A2016018; the Specialized Research Fund for the Doctoral Program of Higher Education, No. 20120171120075; a grant from the Science and Technology Project of Guangdong Province of China, No. 2014A020212479; a grant from the Science and Technology Program of Guangzhou City of China, No.201300000174; a grant from the Science and Technology Project of Guangdong Province of China, No. 2016A010103012; a grant from the Doctoral Start-up Project of the Natural Science Foundation of Guangdong Province of China, No. 2017A030310302.

Abstract:

Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused
on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function after replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, repair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replantation of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation provides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.

Key words: nerve regeneration, fingertip replantation, neurological function, microsurgery, hand surgery, anatomy, plastic surgery, blood vessels, neural regeneration