Abstract：Objective To introduce the clinical application of using the single central artery bifurcation technique for Tamai's zone Ⅰ distal replantation.Methods From September 2013 to February 2015, 27 patients (27 fingers) of Tamai's zone Ⅰ distal amputation were retrospectively followed in Xuzhou Central Hospital. There were 16 males and 11 females, aged 18-51 years. Among them, the thumb was involved in 3 cases, the index finger in 9 cases, the middle finger in 7 cases, the ring finger in 5 cases, and the little finger in 3 cases. The single central artery bifurcation technique was used for treatment. Main outcome measures included the finger appearance, nails smoothness and finger sensation. Patients were scored using the Tamai's scale.Results All fingers were replanted successfully without evidence of arterial insufficiency or venous congestion. The wound healed by first intention, and partial necrosis was not identified postoperatively in any fingers. Twenty-five patients were successfully followed up for 6 to 20 months (average, 13.3±3.5 months) . At the final follow-up, the fingers appearances were satisfactory, nails were neady smooth, and no obvious atrophy of finger was found. The finger-pulp mean values of static 2-point discrimination were 5.4±0.7 mm (range, 4.5-6.5 mm) . In our series, based on the Tamai's classification, the results were excellent in 24 cases, good in 1 case, with anthe excellent and or good rate of was 100%.Conclusions The single central artery bifurcation technique can be used safely, with high survival rate which is an ideal choice to promote growth of nail when there was no volar vein, dorsal vein, or second artery available in the amputated part for standard venous drainage.
冯仕明, 王爱国, 程建, 张在轶, 孙擎擎, 周明明, 郝云甲. 利用中央动脉分支静脉化重建Tamai Ⅰ区断指回流的临床应用[J]. 中华解剖与临床杂志, 2017, 22(6): 486-490.
Feng Shiming,Wang Aiguo,Cheng Jian,Zhang Zaiyi,Sun Qingqing,Zhou Mingming,Hao Yunjia. Clinical application of using single central artery bifurcation technique for Tamai's zone Ⅰ distal replantation. Chinese Journal of Anatomy and Clinics, 2017, 22(6): 486-490.
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