Abdominal Pocket Method as a Salvage Procedure for Vascular Insufficiency After Distal Digital Replantation.

Purpose: To assess the utility of abdominal pocketing of a deepithelialized reattached digit to allow for neovascularization as a salvage procedure for circulatory insufficiency after digital replantation. We performed this method in Tamai zone II cases in which microsurgical vascular anastomosis was expected to be difficult based on the findings at the initial operation.

Materials And Methods: From 2008 to 2014, 5 injured digits from 5 patients (mean age, 34 years; range: 25-54 years) underwent the abdominal pocket method as a salvage procedure for postoperative circulatory insufficiency.

Nonincisional osteotomy for gradual lengthening by callus distraction in the hand and foot.

Gradual lengthening by distraction osteogenesis is widely used for brachydactyly. The most frequent postoperative complaint of the patients treated with this method is the appearance of the scar caused by the skin incision for the osteotomy, which is an integral technique of distraction osteogenesis. A nonincisional approach to osteotomy would reduce the dorsal scarring.

Arthrodesis of the distal interphalangeal joint using a bioabsorbable rod as an intramedullary nail.

There are several fixation techniques for arthrodesis of the distal interphalangeal joint. Since February 1999 we have used a bioabsorbable (poly-L-lactide, PLLA) rod as an intramedullary nail for arthrodesis of 15 distal interphalangeal joints and one interphalangeal joint of the thumb. The advantages include the absence of protruding hardware that would require removal, and technical simplicity.

Osteosynthesis in digital replantation using bioabsorbable rods.

There are several fixation techniques for osteosynthesis in digital replantation. Kirschner wire fixation is used commonly but the wires protrude and disturb mobilization. Moreover, it requires removal.