Replantation of amputated fingertips: reconstruction of circulation via proximal subungual arch artery or nail bed vein anastomosis - Report - MDSpire

Replantation of amputated fingertips: reconstruction of circulation via proximal subungual arch artery or nail bed vein anastomosis

  • By

  • Heyun Cheng

  • Heng Xie

  • Shuang Liu

  • Shuai Dong

  • Jihui Ju

  • Qiang Zhao

  • Benyuan Wang

  • Quanwei Guo

  • Xiaoyu Yu

  • Kai Wang

  • June 29, 2026

  • 0 min

Share

Clinical Report: Reattachment of Severed Fingertips via Alternative Anastomosis

Overview

This study evaluates a novel surgical approach for replantation of distal fingertip amputations when traditional arterial and venous anastomosis options are unavailable. The use of the proximal subungual arch artery and proximal nail bed vein for anastomosis is described.

Background

The incidence of finger amputation injuries has increased due to mechanization. Traditional methods often fail when key vascular structures are absent, necessitating alternative approaches to restore blood flow. This study introduces new anastomosis techniques.

Data Highlights

ParameterValue
Mean warm ischemia time4.75 h (range: 3–11 h)
Mean operative time1.97 h (range: 0.5–2.83 h)
Survival of replanted digits12/12
Function scores (mean)12.5 (range: 11–15)
Follow-up duration12.17 months (range: 3–43 months)

Key Findings

  • Proximal subungual arch artery can effectively replace the palmar digital artery for arterial supply.
  • Proximal nail bed vein can serve as an alternative to the subcutaneous vein for venous drainage.
  • All 12 digits in the study survived without complications.
  • The mean function score of the affected fingers was 12.5.

Clinical Implications

The study presents the proximal subungual arch artery and proximal nail bed vein as options for replantation in cases where traditional vessels are unavailable.

Conclusion

The study demonstrates alternative anastomosis techniques for distal fingertip replantations.

Related Resources & Content

  1. Author(s)/Org, Source, Year -- Title
  2. Total avulsion of the heel pad accompanied by talar and calcaneal fractures: management through multiple K-wire fixation, internal stabilization, and free ALT flap reconstruction
  3. Repair lower extremity vascular injury using a parallel connection for reconstruction of vessel graft with autogenous vein
  4. Reconstruction of the Thumb Following Radical Tumor Resection Utilizing a Free Osteocutaneous Lateral Arm Flap with Subsequent Humerus Fracture: A Case Study
  5. Digit Replantation - StatPearls - NCBI Bookshelf
  6. Outcomes of Artery-Only Digital Replantation
  7. sentara — Sentara Plastic Surgeon Used Patient's Toe to Replace Severed Thumb
  8. Digit Replantation - StatPearls
  9. Outcomes of Artery-Only Digital Replantation
  10. Frontiers | Replantation of Amputated Fingertips: Reconstruction of Circulation via Proximal Subungual Arch Artery or Nail Bed Vein Anastomosis

Original Source(s)

Replantation of amputated fingertips: reconstruction of circulation via proximal subungual arch artery or nail bed vein anastomosis

  • by Heyun Cheng, Heng Xie, Shuang Liu, Shuai Dong, Jihui Ju, Qiang Zhao, Benyuan Wang, Quanwei Guo, Xiaoyu Yu, Kai Wang

  • June 29, 2026

Related Content

Analysis of the factors influencing reoperation for severe finger scar contracture in children—clinical data analysis of 61 children

Prehabilitation Program May Benefit Patients Undergoing CRC Surgery

Structured implementation increased participation and improved preoperative fitness, while postoperative complication and mortality rates remained similar across groups.

30-Day Outcomes of Simultaneous Sleeve Gastrectomy and Kidney Transplantation: An Analysis from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Database