ABSTRACT
One-hundred and twenty-seven digits in Verdan zones I and II, and 24 thumbs in 106
patients were reviewed from 1979 to 1995. Patients were all followed fora minimum
of 5 months to assess early results and complications, and to determine if a short
course (minimum 3 days) of dextran 40 anticoagulation adversely affected digit survival.
The total survival rate was 88 percent. Digits with only a single artery and vein
repaired had a significantly higher rate of failure (p > .05). Index and small fingers also showed a trend toward lower survival. Vein grafts
were used in 22 percent of cases. No vascular problems were noted after 5 days.
Variables not affecting survival were: presence of a joint fusion, type of fixation,
level of injury, number of digits, mechanism of injury, and use of vein grafts. The
average hospital stay for the group was 6.5 days (± SD 3.3). No complications were
seen with dextran use. A total of 51 complications were seen overall and the non-union
rate was 10 percent.
Community-based replantation and revascularization can be performed with early results
equivalent to prior published studies. Complications are to be expected and demand
expeditious treatment. Functional recovery of severed digits remains the benchmark
for success in these injuries; however, lost digits never work.
