Nail regeneration in digits replanted after amputation through the distal phalanx

Nishi, Genzaburo; Shibata, Yoshimori; Tago, Kyoji; Kubota, Masaya; Suzuki, Misako

doi:10.1016/s0363-5023(96)80105-5

Cited by 27 publications

(13 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nail regeneration in replanted digits depends on whether the sterile or germinal matrix is injured, the type of injury (clean-cut versus crushed amputations), and the post-operative circulatory conditions. 53 It is difficult to relate the level of nail bed injury to the level of amputation as both the Tamai zone I and the Ishikawa sub-zone II amputations include a small portion of the germinal matrix (the lunula). Pulp atrophy is believed to be related to type of injury and post-operative vascular complications.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Outcomes of Replantation of Distal Digital Amputation

Sebastin¹,

Chung²

2011

Plastic and Reconstructive Surgery

241

230

View full text Add to dashboard Cite

Background The aim of this study is to conduct a systematic review of the English literature on replantation of distal digital amputations to provide the best evidence of survival rates and functional outcomes. Methods A MEDLINE search using “digit, finger, thumb, and replantation” as keywords and limited to humans and the English language identified 1297 studies. Studies were included in the review if they: (1) present primary data; (2) report 5 or more single or multiple distal replantations; (3) present survival rates. Additional data extracted from the studies meeting the inclusion criteria included demographic information, nature and level of amputation, venous outflow technique, nerve repair, recovery of sensibility, range of motion, return to work, and complications. Results 30 studies representing 2,273 distal replantations met the inclusion criteria. The mean survival rate was 86%. There was no difference in survival between zone I and zone II replantations (Tamai classification). There was a significant difference in survival between replantation of clean-cut versus the more crushed amputations (crush-cut and crush-avulsion). The repair of a vein improved survival in both zone I and zone II replantation. The mean 2-PD was 7mm (n=220) and 98% returned to work (n=98). Complications included pulp atrophy in 14% of patients (n=639) and nail deformity in 23% (n=653). Conclusion The common perception that distal replantation is associated with little functional gain is not based on scientific evidence. This systematic review showed a high success rate and good functional outcomes following distal digital replantation.

show abstract

Section: Discussionmentioning

confidence: 99%

A Systematic Review of the Outcomes of Replantation of Distal Digital Amputation

Sebastin¹,

Chung²

2011

Plastic and Reconstructive Surgery

241

230

View full text Add to dashboard Cite

show abstract

“…In children in particular we prefer avoiding a surgical procedure [16]. Skin grafts are associated with more tenderness, cold intolerance, and diminished sensitivity than what is seen after secondary healing [5, 11, 22, 28, 34, 35]. …”

Section: Discussionmentioning

confidence: 99%

“…Like local skin flaps, they are associated with a certain rate of failure and other complications such as infection, joint stiffness, hyperesthesia, or poor sensation [18, 35, 37, 38, 44, 46–55]. …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Digital Tip Amputations from the Perspective of the Nail

Champagne

Hustedt

Walker

et al. 2016

Advances in Orthopedics

View full text Add to dashboard Cite

The management strategy proposed herein for fingertip amputations advocates secondary healing with preservation of appearance as well as function. Conservative healing is more likely to result in a sensate, nontender, and cosmetically acceptable fingertip compared to surgical management in many clinical scenarios. This manuscript examines in detail the extent of fingertip injury and defines the relationship of injury to final fingertip outcome. A classification is presented, which allows adequate initial counseling regarding prognosis, and predicts the need for secondary corrective surgery.

show abstract

“…We recommend repairing the germinal matrix with 8-0 absorbable suture using an operating microscope or surgical loupe. 16 Germinal matrix peeled from the base should be replaced and repaired with mattress sutures. The removed nail plate can be fixed using the Schiller method.…”

Section: Discussionmentioning

confidence: 99%

Fingertip Replantations: Importance of Venous Anastomosis and the Clinical Results

et al. 2009

Self Cite

View full text Add to dashboard Cite

Overall survival rate for 143 digits with complete amputation of the distal phalanx was 78%. Replanted digits that underwent venous anastomosis showed a very high survival rate of 93%. Loss of the distal interphalangeal joint function in subzone IV was significantly inferior to that in subzones II and III. Protective sensation was achieved in 96% of replanted digits. Sensory recovery in the absence of nerve repair was significantly worse for avulsion injury than for crush injury. Nail deformity tended to be increased for replanted digits in subzone III or with crush-type injury. Successful venous anastomosis appears to offer the best way to promote survival of replanted digits. If venous anastomosis is infeasible, a replanted digit can survive with any methods for venous drainage in subzones II and III, but does not survive in subzone IV. To minimise nail deformity, repair of the germinal matrix is necessary.

show abstract

Nail regeneration in digits replanted after amputation through the distal phalanx

Cited by 27 publications

References 3 publications

A Systematic Review of the Outcomes of Replantation of Distal Digital Amputation

A Systematic Review of the Outcomes of Replantation of Distal Digital Amputation

Digital Tip Amputations from the Perspective of the Nail

Fingertip Replantations: Importance of Venous Anastomosis and the Clinical Results

Contact Info

Product

Resources

About