Tamai Zone 1 Fingertip Amputation: Reconstruction Using a Digital Artery Flap Compared With Microsurgical Replantation

Favoured treatments for fingertip defects and finger amputation distal to the distal interphalangeal joint in my unit and in Japan

“…Crush or avulsion amputations may have poor sensory recovery after replantation and sometimes results in atrophic fingertips because neurorrhaphy and venous anastomosis are difficult or impossible to achieve. I consider that a graft or flap procedure (Netscher and Meade, 1999) may have better outcomes than a replantation in this situation, which is supported by a recent study from our unit (Nakanishi et al., 2019).…”

“…We recently published an article retrospectively comparing the clinical results of two surgical procedures for Tamai Zone 1 fingertip amputations of the index or middle finger: reconstruction with a digital artery flap and microsurgical replantation (Nakanishi et al., 2019). The study was sufficiently powered with 14 fingers in the replantation group and 23 fingers in the digital artery flap group.…”

Improved Abdomen Hypodermic Embedding for Salvage of the Amputated Fingertip from Tip to Lunula (Tamai Zone Ⅰ)

“…Emin Sir introduced a novel method called reposition ap repair, which could preserve the length and sensory functions of the ngertip [17]. Akito Nakanishi discovered that reconstruction using a digital artery ap and microsurgical replantation were comparable regarding postoperative activities of daily living and hand performance, but reconstruction gave better objective functional outcomes such as strength, digital sensitivity and nger mobility [18]. Although the above method is effective, the large trauma to the nger and the bloated appearance are also unsatisfactory.…”

Finger amputations and pulp defects distal to the distal interphalangeal joint

“…A flap should be adopted if microsurgery is not possible because of the extent of injury. The sensory recovery of these flaps was found superior over the replanted fingertip in a comparative study (Nakanishi et al., 2019). Factors affecting the decision-making are the condition of the amputated segment (characteristics and mechanism of the amputation), the age of the patient, and the technical ability of the surgeon.…”