Clinical application and anatomical study of Arterio-Venolization in Replantation of the Severed Fingers

Abstract Objective To investigate the feasibility of arteriovenous operation in the replantation of the severed finger. Methods 65 patients with distal finger segment disjunction admitted from January 2014 to August 2021 were selected. According to the severity of finger injury, existing blood vessels and soft tissue conditions of the patients, the vascular anastomosis was determined, and they were grouped according to different blood vessel merging methods. Clinical comparison of postoperative effects between group A (12 cases of arterio-venolization replantation fingers) and group B, C and D (25 cases, 9 cases, 19 cases). After 1 to 7 years of follow-up and study. Meanwhile,In January 2022, ten isolated finger specimens were collected.The vascular routes and distribution were analyzed under the microscope, and the relationship between the arteriovenous arch and the body surface location markers was defined. The preferred vascular path of arterio-venolization was confirmed again.Results There were no significant differences in survival rate, length of hospital stay,the number of vascular crisis and skin necrosis between group A and B (P > 0.05). However,the length of hospital stay, the rate of partial skin necrosis and the incidence of vascular crisis in group C and D were higher than those in group A and B, and the survival rate of replantation finger was lower than that in group A and B (P < 0.05). In the anatomy process of the finger specimens, it was found that the nail base line was clearly and accurately used as the body surface positioning mark. There were a variety of arterio-venolization surgery options as the blood flow artery and the vein with a better match. The veins with a diameter of about 0.3-0.5mm on the lateral side of the non-dominant lateral nail groove of the proximal finger were preferred as the docking vessels. The distal artery was anastomosed with the proximal vein by super microscopic technique, and the anastomosis with the normal artery-to-artery on the other side formed a closed blood flow loop. Conclusion With no vein anastomosis, the treatment of distal finger amputation with super micro combined with arterio-venolizationis is convenient, safe and effective.