ABSTRACT
Microsurgical treatment of ring avulsion injuries is often difficult, due to widespread
intimal damage of the digital vascular bundles. Thirty-one patients with such injuries
in varying degrees were treated during the period 1986 to 1992: of these, 15 underwent
microsurgical revascularization. In addition to the traditional procedures applied
in seven patients (arteriolysis, direct vessel suture, vein grafts), a technique consisting
of vessel transfer from the middle finger was also employed. In five patients, the
ulnar digital artery of the middle finger was transferred to the ring finger. In four
patients, at least one vein was transferred from the dorsal aspect of the middle finger.
Twelve of 15 microreconstructions were successful: with an average follow-up of 48.3
months, these patients showed very good functional (mean total active range of motion:
234° and mean s2PD: 9.8mm) and cosmetic recovery. These results lead to the conclusion
that, except for cases characterized by proximal amputation at the flexor superficialis
tendon insertion, microsurgical treatment should always be carried out.
