THE PRIMARY USE OF VENOUS GRAFTS
IN THUMB REPLANTATION
Sukop A., Tvrdek M., Kufa R.
Department of Plastic Surgery, University Hospital Královské Vinohrady, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic |
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Summary:
The authors describe modified thumb replantation technique. With this technique it is possible to avoid extensive
mobilization of the digital arteries as well as incisions, particularly at the distal thumb phalanx, and therefore reduce
further damage of the amputated part. Prior to the osteosynthesis a venous graft is harvested from the distal forearm
or from the thenar area. Anastomosis between the venous graft and radial digital artery on the amputated part
of the thumb is completed. Osteosynthesis of the bones with Kirchner wires follows. The venous graft is further
anastomosed to the dorsal venous system of the stump. The arterial system is reconstructed with an anastomosis
of the ulnar digital artery with a superficially positioned volar vein of the amputated part. The replantation technique
described has proved effective in all cases when it was used.
Key words:
microsurgery, replantation, arteriovenous shunt, hand surgery, thumb replantation, venous graft
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