Replantation of Completely Amputated Thumbs With Venous Arterialization

Purpose To report a new method of replanting completely amputated thumbs with venous arterialization. Methods In 6 replantation surgeries of completely amputated thumbs performed during the period 1999–2003, the proximal artery was anastomosed with a vein of the amputated part to establish inflow and the proximal vein was anastomosed with several other veins in the amputated part to establish outflow. This was because the proper palmar digital arteries were seriously injured or anastomosis of proper palmar digital arteries failed many times. Results All the replanted thumbs survived, regained good sensory and motor functions, and showed no difference from thumbs replanted conventionally. Conclusions Venous arterialization may salvage otherwise unreplantable thumbs. Type of study/level of evidence Therapeutic IV.