Intramedullary Venous Drainage System for Distal

Abstract: The number of venous anastomoses performed during fingertip replantation
is one of the most important factors affecting the success of replantation.
However, because vessel diameters decrease in the zone 1 level, vessel
anastomoses, especially vein anastomoses, are technically difficult and, thus,
cannot be performed in most cases. Alternative venous drainage methods are
crucial when any reliable vein repair is not possible. In the literature, so many
artery-only replantation techniques have been defined, such as arteriovenous
anastomoses, forming an arteriovenous or venocutaneous fistula, manual
milking and massage, puncturing, and external bleeding via a fishmouth incision
and using a medical leech. It has been shown that, in distal fingertip replantations,
the medullary cavity may also be a good way for venous return.
In this study, we introduce an alternative intramedullary venous drainage system
we developed to facilitate venous drainage in artery-only fingertip replantations.
The results of 24 fingertip replantations distal to the nail fold by using
this system are presented with a literature review.

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