|Microsurgery: Transplantation and Replantation by Harry J. Buncke, MD, et al.|
| FIG. 32-10. Bony fixation has been performed with perpendicular intraosseous wires, predrilled into the amputated digits. The perpendicular wires reduce rotation and provide moderate compression, and in our unit, they have had the lowest nonunion rate.
A 22-year-old mover caught his dominant hand beneath the power tailgate of a moving van, resulting in a crushing, devascularizing injury to the proximal phalanges of four fingers. The patient arrived 5 1/2 hours after the original injury, and revascularization was begun after 6 hours of warm ischemia.
FIG. 32-13. X ray shows fixation.
A 22-year-old man suffered a transmetacarpal amputation of his nondominant hand in a quarry accident. Despite the avulsive nature of the tendon injury, the remaining structures were sharply divided and with minimal traction damage. As a manual laborer, the patient wished replantation if possible despite the prolonged reconstructive course.
FIG. 32-18. Preoperative x ray view shows the extensive tendon injury.
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