Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part.
10.5999/aps.2012.39.4.404
- Author:
Mi Sun JUNG
1
;
Young Kook LIM
;
Yong Taek HONG
;
Hoon Nam KIM
Author Information
1. Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital, Daegu, Korea. plastika@naver.com
- Publication Type:Original Article
- Keywords:
Amputation;
Finger;
Replantation
- MeSH:
Adult;
Amputation;
Cosmetics;
Fingers;
Humans;
Nails;
Necrosis;
Replantation;
Transplants
- From:Archives of Plastic Surgery
2012;39(4):404-410
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. METHODS: Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. RESULTS: Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. CONCLUSIONS: A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.
