PubMed · 790528
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R Tubiana, A Gilbert. 1976-09-21. [Microsurgery and reconstructive surgery].. https://pubmed.ncbi.nlm.nih.gov/790528/
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Twenty-five cases of avulsive amputation of the thumb are reported. Twenty-one of the 25 cases were categorized as Grade I avulsions (little or no skin defect) and four were categorized as Grade II avulsions complicated by a large skin defect. Three different replantation techniques were used and compared: (1) direct vessel anastomosis, (2) arterial anastomosis between the superficial branch of the radial artery and distal end of the thumb, and (3) arterial anastomosis after artery transfer from other digits. The authors concluded that direct vessel anastomosis was not the preferred method and that technique 2 could be used in any case but was especially suited to Grade II reconstructions. Technique 3 is mainly used in Grade I avulsions.
During the last 4 years, three infants have presented with finger-tip injuries secondary to entrapment in woollen/synthetic mittens. The accident happened at home in one case but the other two occurred in different neonatal units. Spontaneous amputation of the terminal phalanx of the index finger occurred in two patients but in the other there was complete healing. This problem may be avoided by restricting the use of mittens, by changing their design, and by a greater awareness of this hazard.
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