Arterial and venous revascularization with bifurcation of a single central artery: A reliable strategy for tamai zone i replantation

Chung Chen Hsu, Yu Te Lin, Steven L. Moran, Cheng Hung Lin, Fu Chan Wei, Chih Hung Lin

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Replantation of the distal phalanx and pulp can be performed to improve finger function and finger aesthetics; however, establishing adequate venous drainage is a challenge. Slattery et al. reported microsurgical reattachment of a partial distal phalanx with the use of a bifurcated terminal digital artery. The bifurcation was divided into two pedicles, one of which was used for venous drainage. In this article, the authors report their experience with a similar technique and propose a new algorithm for distal finger replantation. Methods: From January of 2008 to February of 2009, five replantations were performed using a single central artery. The replanted levels were pulp, avulsed fingertip of the thumb, and distal phalanges. There was no volar vein, dorsal vein, or second artery available in the amputated part for standard venous drainage. Venous drainage in all cases was established by creating an anastomosis from a branch of the solitary terminal artery to a recipient vein. Results: All digits were replanted successfully without evidence of arterial insufficiency or venous congestion. Partial necrosis was not identified postoperatively in any of the five fingers. There were no cases of wound infection. Conclusions: A branch of the central solitary artery may be used successfully to reestablish venous outflow in cases of distal finger tip replantation. This technique allowed for the salvage of all fingers in this study without the use of leeches or other techniques used in cases of venous insufficiency.

Original languageEnglish (US)
Pages (from-to)2043-2051
Number of pages9
JournalPlastic and reconstructive surgery
Issue number6
StatePublished - Dec 1 2010

ASJC Scopus subject areas

  • Surgery


Dive into the research topics of 'Arterial and venous revascularization with bifurcation of a single central artery: A reliable strategy for tamai zone i replantation'. Together they form a unique fingerprint.

Cite this