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Multiple partial traumatic amputations

Patient suffered multiple partial traumatic amputations of the fingertips while operating a hydraulic cutter, severed finger were replanted using microsurgical technique!! When possible, the amputated part should be taken to the operating room before the patient for thorough debridement and examination under the microscope. The quality of the tissue, specifically the nerves and blood vessels, are examined before committing to the replantation. Identifiable structures should be tagged with suture or microclips. The first step in replantation is bone shortening and fixation. Bone should be shortened enough to take all tension off of the subsequent soft tissue repairs. Bony fixation is followed by extensor tendon then flexor tendon repair. Arterial repair should then be undertaken. No matter what the level of amputation, anastomosing intact and healthy arterial intima on each side of the repair is paramount to success.Nerve repair is then completed followed by vein repair. Lastly, soft tissue coverage of the repair is completed. Credit: @reconst.surg.col @medicalpedia