Replantation of Amputated Digits

We report the surgical result of replantation of amputated digits during a five year period. From January 1992 to September 1996, we had 24 patients (21 males and three females) with amputation of 40 digits (eight thumb, eight index fingers, twelve long fingers, six ring fingers, six little fingers). The patient's age ranged from four to 62 years (mean 40 years). Surgical delay from the time of injury ranged from three to 25 hours (mean seven hours). According to Tamai's classification of the territory of digital amputation, no patients were Zone I, three were Zone II, nine Zone III, 24 Zone IV and four Zone V. According to Yamano's classification of the amputated condition, there were no sharp cut amputations, 34 blunt cut amputations, five avulsion cut amputations and one crush cut amputation.Success rate of replantation in this series was 92% (37 of 40 digits). Failed replantations included amputation in Zone II (blunt cut and avulsion cut one each) and a crush cut amputation in Zone V. The territory of amputation and condition of the amputated digits had a greater affect on success rate than the surgical delay.