Replantation of the digits amputated by motorcycle chain injury

Over the past 5 years, 134 digits were replanted in 85 patients. In 9 patients — 10 digits (11%) — the causation of injury was a motorcycle chain. The significant incidence of this type of injury has prompted us to report the replantation results. Hopefully, this might be used to caution the public against cleaning the chain while it is in motion. The sites of amputation were 5 in Tamai's Zone I and 5 in Tamai's Zone II. All amputated parts were distal to the DIP joint. The digits were replanted with anastomosis of both the artery and the vein. Eight out of the 10 replanted digits survived to give a success rate of 80%. There was no statistical difference between this rate and that for all other replanted digits resulting from various causes in Zones I and II, i.e. 86%. The high success rate suggests that replantation of the chain-amputated digits should be recommended, and the apparently poor conditions of the crush injury are no contraindications for surgery.