Use of Low-profile Palmar Internal Fixation in Digital Replantation.

There are multiple surgical techniques to stabilize the bone in digital replantation. Various criteria need to be considered when choosing appropriate bony fixation including operative time, ease of exposure, stability, limitation of the area of dissection, and reproducibility. We describe our technique using internal fixation with a low-profile plate on the palmar aspect of the proximal or middle phalanx during replantation of a digit. This technique allows coverage of the plate with no risk of compromising the dorsal venous anastomosis. In our experience, using this technique we have observed no complications including no secondary displacement of the fragments or extensor tendon rupture and no incidence of infection. In addition, this technique allows adequate bony fixation to enable an early active range of motion rehabilitation program.