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

Abstract

Background To explore the clinical efficacy of a new surgical approach called improved abdomen hypodermic embedding for salvage of the amputated fingertip from tip to lunula (Tamai zone Ⅰ). Methods From September 2015 to June 2017, we treated 18 fingertips from 15 patients with abdomen hypodermic embedding while all the fingertips were completely amputated and failed to vascular anastomose. After 3 weeks, all the fingertips were taken out from abdomen. After 6 months, outcomes were evaluated with DASH score and static two-point finger discrimination. Results 16 fingertips survived completely, 2 fingertips developed partial loss and scar healed by dressing change. All patients were satisfied with the appearance of the fingertips while one woman was not satisfied for ischemic atrophy. The DASH score ranged from 35-46 (average 38), static two-point discrimination was 6--14mm (average 8mm). Conclusions When vascular anastomosis is not feasible in fingertip replantation, improved abdomen hypodermic embedding is a simple and feasible operation for the amputated fingertip from tip to lunula.