Chen Y, Wang ZM, Yao JH. Supermicroscopy and arterio-venolization for digit replantation in young children after traumatic amputation: Two case reports. World J Clin Cases 2020; 8(21): 5394-5400 [PMID: 33269275 DOI: 10.12998/wjcc.v8.i21.5394]
Corresponding Author of This Article
Jing-Hui Yao, MSc, Associate Chief Physician, Department of Pediatric Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183 Zhongshan Avenue West, Guangzhou 510630, Guangdong Province, China. yaojinghui2004@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2020; 8(21): 5394-5400 Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5394
Supermicroscopy and arterio-venolization for digit replantation in young children after traumatic amputation: Two case reports
Yun Chen, Ze-Min Wang, Jing-Hui Yao
Yun Chen, Department of Pediatric Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510000, Guangdong Province, China
Ze-Min Wang, Department of Pediatric Orthopedics, Loudi Central Hospital, Loudi 417000, Hunan Province, China
Jing-Hui Yao, Department of Pediatric Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, Guangdong Province, China
Author contributions: Yao JH and Chen Y contributed equally to this work; Yao JH and Chen Y designed the research study; Yao JH and Wang ZM completed these operations; Chen Y and Wang ZM completed the postoperative observation; Chen Y and Wang ZM analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Hui Yao, MSc, Associate Chief Physician, Department of Pediatric Orthopedics, The Third Affiliated Hospital of Southern Medical University, No. 183 Zhongshan Avenue West, Guangzhou 510630, Guangdong Province, China. yaojinghui2004@163.com
Received: July 3, 2020 Peer-review started: June 27, 2020 First decision: September 12, 2020 Revised: September 23, 2020 Accepted: October 1, 2020 Article in press: October 1, 2020 Published online: November 6, 2020
Abstract
BACKGROUND
To report the application of supermicroscopy combined with arterio-venolization without venous anastomosis for replantation of digits following traumatic amputation in young children.
CASE SUMMARY
In March 2016, we treated two children aged 2 years and 7 years with traumatic digit amputation, no venous anastomosis, and bilateral digital inherent arteries on the palmar side. Supermicroscopy combined with an arteriovenous technique was adopted to improve the replantation surgery. Postoperative management involved auxiliary treatments such as anticoagulation, composure, anti-inflammatory drugs, and insulation. After treatment, the amputated fingers survived completely without major complications, with good recovery.
CONCLUSION
Supermicroscopy combined with arterio-venolization is a safe and effective approach to treat traumatic digit amputation in young children without venous anastomosis.
Core Tip: Young children with traumatic digit amputation and no venous anastomosis are considered a technical challenge clinically. Traditional surgical methods, flap repair, in situ suture, and only suture of the artery and blood-letting therapy have been used for treatment, with low success rate, perioperative complications, pain, and poor prognosis. Supermicroscopy combined with arterio-venolization is effective for digit replantation, without causing new donor site injury but with a high survival rate, finger integrity preservation, and good prognosis.
