We reviewed fifty-nine consecutive cases of patients who had
replantation of a single finger (excluding the thumb) after traumatic
amputation, with an average follow-up of fifty-three months. Fifty-one (86
per cent) of the replanted fingers survived. Survival was found to be
affected by the age of the patient, the number of vessels that were
anastomosed, and the replantation experience of the surgeons. The survival
rate was not affected by the gender of the patient, the mechanism of
injury, or which finger was amputated. As compared with survival only, the
functional results were most dependent on the level of amputation. The
proximal interphalangeal joint in amputated fingers that were replanted
distal to the insertion of the flexor superficialis tendon had an average
range of motion of 82 degrees after replantation, while those amputated
proximal to the insertion had an average range of motion of only 35 degrees
after replantation. The average operating time was six hours and ten
minutes, and the average time until the patient returned to work was 2.3
months. Based on this experience, it is our opinion that replantation of a
single finger that was amputated distal to the insertion of the flexor
superficialis tendon is justified, but that replantation of a single finger
that was amputated proximal to this insertion is seldom indicated.