|Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.|
| This case involved restoration of pulp substance in the index finger. (From Buncke, H.J., and Rose, E.H.: Free toe-to-fingertip neurovascular flaps. Plast. Reconstr. Surg. 63:607 1979.)
FIG. 2-15. The entire pulp substance of the pinch area of the index finger has been lost after a snakebite injury.
Transplantation from Finger to Finger
As mentioned earlier, neurovascular island flaps have been transferred on intact pedicles to resurface critical pinch areas. An expansion of this concept is useful on both acute and elective situations to restore maximal function following multidigit amputation.
The replantation surgeon is often presented with a multidigit injury concomitantly involving the nonreplantable destruction of the thumb. Mindful of the critical role the thumb plays in hand function, a first priority is restoration of thumb function.
One strategy is to use an undamaged portion of an amputated digit as an immediate heterotopic replant to reconstruct the thumb where replantation of the amputated thumb itself is not possible. 7 Our results have been gratifying, and we have used this concept electively to improve hand function.
Hand-to-hand Digital Transplants
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