Proximal interphalangeal replantation

A 57-year-old woman suffered from incomplete amputations at the level of the PIP joint of the right index finger without distal circulation, along with crush fracture on the proximal phalangeal bone of middle, ring and little fingers due to being caught in the rotor of a food processor (Fig. 1, ​2).

The patient underwent revascularization and PIP joint arthrodesis at an angle of 45° of the index finger, and reduction and K-wire fixation of the other three fractured fingers (Fig. 3). Good form and acceptable function in opposition and grasp were evident 15 months later, while the TAM was 80° and the DASH score was 15 points (Fig. 4​, 5).

Figure 1. Click to unblur
Figure 2
Figure 3. Intra-operative photograph shows exposure of PIP joint. Click to unblur
Figure 4. The picture 15 months after surgery shows good form and acceptable function in opposition.
Figure 5. An X-ray image 15 months after surgery shows bone union of PIP joint of index finger