Microvascular replantation in a seven‐month‐old girl: A case report

Abstract

Replantation of an amputated digit in a child demands special techniques for success. Our experiences with replantation in this age group have shown that although these patients have a lower viability rate after digital replantation, those digits that do survive develop excellent function. In this case report of a 7-month-old with an amputated thumb, the indications, techniques, and prognosis of replantation in children are discussed.

Fingertip replantation at or beyond the nail base in children

“…18,19 Therefore, Saies et al advised that replantations at any level in children should be tried if at all technically possible. 20 However, very distal digit replantations of pediatric cases could be rather technically difficult.…”

“…A study indicates that the vessel caliber of these terminal vessels vary from 0.3 to 0.7 mm in adults, 21 whereas correspondingly the vessel diameter in children might be less than 0.5 mm. 18 Anastomosis of such small vessels is technically demanding and requires a high-power operating microscope. In this series, with the use of 11.0 or 12.0 sutures, we conducted neurovascular repairs under 253 to 303 magnifications.…”

Successful Replantation of a Finger in an 8-Month Old Child

“…2 In a review of 41 digital replants in 33 children under 34 months of age, the youngest case was in a 9.3-month-old child. 3 Large reviews of pediatric replantations do not describe successful procedures in children younger than one year of age.…”

Replantation in children

“…3,4 Vessels as small as 0.3 and 0.4 mm have been repaired successfully. 2,5 Saies et al 6 advised that replantation and revascularization procedures should be performed in children who have had almost any complete or incomplete amputation at any level when technically possible. Pediatric replantations have different properties than those in adults.…”

“…1 Because the vessel diameter might be less than 0.5 mm in children, replantation process on the digital amputations is technically demanding. 2 Advances in microsurgical techniques have been permitted replantation and reconstructive procedures to restore injured parts with a high degree of success in children. 3,4 Vessels as small as 0.3 and 0.4 mm have been repaired successfully.…”