In cases of replantation, accurate closure of all structures, including bone, tendons, arteries, nerves, and veins is essential. Among these, the vein is a weaker structure and is damaged severely in most amputation cases. After fixation of bone, repair of tendons, nerves, and arteries, surgeons often experience difficulty in performing venous anastomoses. We found that in such cases, venous anastomosis is easy to perform using an additional incision after closure of the original wound. In a 33-year-old male patient with amputation of all four fingers at the metacarpophalangeal joint level, venous anastomoses were performed with dorsal veins using additional incisions after completion of the fixation of bones and repair of all other structures and closure of the skin due to surgical site tension.
Adult ; Amputation ; Arteries ; Fingers ; Humans ; Male ; Metacarpophalangeal Joint* ; Replantation* ; Skin ; Surgeons ; Tendons ; Veins* ; Wounds and Injuries*

Diabetic patients are more susceptible to chronic hand infection. Due to mixed bacterial infection, poor wound healing capacity, associated neuropathy and angiopathy, they suffer mostly from deep hand infection, which necessitates multiple surgeries and reconstruction of the defect. Early partial amputation of the digit followed by coverage of the soft tissue defect by flap and timely physiotherapy can provide satisfactory functional outcome in chronic severe hand infection cases. We report and compare two similar cases of chronic severe diabetic hand infection where differences in timing of partial amputation, coverage of the defect by groin flap and adequate postoperative rehabilitation made a gross difference in the final functional outcome.