Wir überwinden Grenzen

A fingertip or phalanx that has been severed or severely injured in an accident is usually amputated. This is because reconstruction, known as replantation, is very complex and requires experience in the surgery of tiny vessels and nerves. Physicians at the Medical Center - University of Freiburg have now shown in a study that most patients who have undergone successful replantation are very satisfied with the result. Although the operation takes almost four hours on average and requires a longer hospital stay than an amputation, the physicians from Freiburg recommend treating more patients in this way in future. The study was published on April 19, 2017 in the specialist journal Handchirurgie - Mikrochirurgie - Plastische Chirurgie.

"In the long term, most patients benefit from a replantation of the distal phalanx. This is because the feeling and function of the hand can usually be fully restored - in addition to the good aesthetic result," says study leader Prof. Dr. Steffen Eisenhardt, Senior Physician at the Department of Plastic Surgery and Hand Surgery at the Medical Center - University of Freiburg. Although the first successful replantation of a finger phalanx was performed over 50 years ago, physicians and patients still often tend to amputate and decide against a replantation attempt. This is because amputation is technically much easier and those affected can use their finger again more quickly, which is particularly important for freelance tradespeople. "But the loss of a phalanx can be a major restriction for life. This is often overlooked," says Prof. Eisenhardt.

For their study, the physicians from Freiburg evaluated the success of the replantation and the stress caused by the operation in eleven patients. These included a small child, several people who had suffered accidents at work and an over 80-year-old farmer. The patients had bruised, partially or completely torn off or cut off their fingertips. Reconstruction was successful in eight patients. The majority of patients are satisfied with the result. Two thirds of the patients have no restrictions in feeling and function of the finger.

With the microsurgical techniques used by the physicians in Freiburg for replantation, vessels and nerves less than 0.8 millimeters in diameter can be sutured together. These innovative techniques are only possible with many years of training and the appropriate technical equipment and are known as super microsurgery. The Department of Plastic Surgery and Hand Surgery at the Medical Center - University of Freiburg is a pioneer in this technique. Under the direction of Prof. Dr. Björn Stark, Medical Director of the Department of Plastic Surgery and Hand Surgery at the Medical Center - University of Freiburg, the annual conference of the German-speaking Association for Microsurgery of the Peripheral Nerves and Vessels will take place in Freiburg from November 16 to 18, 2017.

Original title of the study: Results after finger end phalanx replantation - Is the effort justified?

DOI: 10.1055/s-0043-102854

Link to the study: www.thieme-connect.de/DOI/DOI?10.1055/s-0043-102854

Contact:
Prof. Dr. Steffen Eisenhardt
Senior Physician
Department of Plastic Surgery
Medical Center - University of Freiburg
Phone: 0761 270-24010
steffen.eisenhardt@uniklinik-freiburg.de