Application of tendon suture in situ in replantation of avulsed severed finger

Objective To explore the surgical method and clinical efficacy of tendon in situ suture in the replantation of avulsed severed finger. Methods From June 2014 to February 2018, 7 cases of severed finger with tendon pulled out from the abdomen were repaired and replanted by in situ embedding suture through the original tunnel. Results All the wounds achieved primary healing and the replantation of severed fingers was successful. There was no vascular crisis after operation. All the patients were follow-up for 6 to 20 months, with an average of 10 months. The replanted finger has good blood supply, good appearance, full belly, and satisfactory function of flexion, extension and opposition. The two-point discrimination of finger pulp was 8 to 14 mm. According to the evaluation criteria of replantation function of severed fingers issued by Hand Surgery Society of Chinese Medical Association, the results were rated as excellent in 5 fingers, good in 1 finger, and fair in 1 finger. Only linear scars were left on the forearm, and wrist flexion and extension were not limited. Conclusion The tendon of avulsed severed finger can be repaired by suture in situ via the original tunnel. The superficial vein and cutaneous nerve can also be harvested from the same incision of forearm to repair the defect of digital artery and nerve. Satisfactory results can be obtained after operation. Key words: Finger injuries; Replantation; Avulsion; Tendon; In situ suture