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This
patient suffered a crush amputation of
two fingers. The amputated parts,
although distal, appear to be in good
condition.
 Inspection
of the palmar surface reveals no obvious
proximal or distal crush
component. There is some
angulation to the amputation making the
palmar cut close to the distal
interphalangeal crease. Although
distal, the fact that two fingers were
involved, and the parts are in good
condition, makes this patient a
favorable candidate for replantation.
 The
amputations were very close to the
distal interphalangeal (DIP)
joint. Plate fixation would have
left the small bone fragments proximal
to the DIP joint devascularized,
impairing healing, and promoting
arthritis of the joints. K-wire
fixation was used to maintain bone
fixation. The proximal
interphalangeal (PIP) joints were left
free, therefore early motion could begin
here.
The patient
is seen below about six months after his
injury. Sensation and excellent
and function is excellent. No
secondary or revision surgery was
required.
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