Author(s): Casal, Diogo ; Gomez, Manuel Mac Emino ; Antunes, Paula ; Candeias, Henrique ; Almeida, Maria Angélica
Date: 2013
Persistent ID: http://hdl.handle.net/10362/147242
Origin: Repositório Institucional da UNL
Subject(s): Amputation; Finger injuries/surgery; Fingers/surgery; Graft survival; Humans; Outcome assessment (health care); Replantation/contraindications/methods; Traumatic/classification; Surgery
Funding Information: Diogo Casal (the first author of the paper) received a grant from “The Programme for Advanced Medical Education” sponsored by “ Fundação Calouste Gulbenkian, Fundação Champalimaud, Ministério da Saúde and Fundação para a Ciência e Tecnologia, Portugal .” Funding Information: Part of this work was funded by “The Programme for Advanced Medical Education” sponsored by “Fundação Calouste Gulbenkian, Fundação Champalimaud, Ministério da Saúde and Fundação para a Ciência e Tecnologia, Portugal.”
INTRODUCTION There is much controversy regarding the current indications and contraindications for digital replantation. PRESENTATION OF CASE Three patients with absolute contraindications for digital replantation according to classical criteria are presented (Case 1: multilevel amputation of the hand and fingers; Case 3: avulsion of the thumb; Case 4: index amputation proximal to the insertion of the flexor digitorum superficialis). In addition a patient with a very distal digital amputation (Case 2), whose indication for replantation is controversial is also presented. In all cases, the patients were replanted and showed good functional and aesthetical results. DISCUSSION Most authors advocate that the classical indications for replantation have been validated by experience, are predicated on the potential for long-term function, and should be followed in most if not all cases. However, some surgeons have been adopting a more liberal attitude with good results. CONCLUSION The clinical cases presented in this paper suggest that the standard criteria for digital replantation should not be followed rigidly but instead should be regarded as a general guide.
