Houston Methodist. Leading Medicine

Hand FAQ

Question:

I lost two fingers in a hunting accident years ago. The surgeon didn't even attempt to reattach them. I see now that not only can the fingers be reconnected but surgeons can connect two fingers together to help the amputated finger recover. How does this process work exactly?

Answer:

It sounds like you may be referring to a newly developed method for restoring blood flow to an amputated finger that has been reattached or replanted. It's called a proximally based cross-finger flap. In this procedure, the surgeon takes the top layer of skin and blood vessels from the finger next to the amputated one (the donor finger) and transfer it to cover the area where the replanted finger is connected back to the affected finger. The donor flap consists of skin, tissue just under the skin, and veins. The tendon is left untouched. The donor flap is sewn loosely without tension to the replanted finger. The flap of skin is not cut away from the donor finger. Instead, it forms what looks like a bridge between the two fingers. The stripped donor site is covered with a layer of skin called a skin graft. When the replanted finger has a restored supply of blood, the graft can be removed. This method may work best when there is venous congestion (blood pooling at the surgical site). It is also used when there is not enough skin to cover and reconnect the amputated finger or it's clear that the replantation is in trouble because of venous congestion. The cross-finger flap is best applied within 48-hours of the original replant surgery. Jianyong Zhao, MD, et al. A Novel Solution for Venous Congestion Following Digital Replantation: A Proximally Based Cross-Finger Flap. In The Journal of Hand Surgery. July 2011. Vol. 36A. No. 7. Pp. 1224-1230.

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