Abstract
PURPOSE: This study reviews distal fingertip replants without heparin, aiming to assess their functional outcomes. METHODS: This retrospective study reviewed all patients who underwent distal fingertip replants in two specialized hand surgery center over 7 years (2016-2023). Patient demographics, injury mechanism, ischemia time, complications, and functional outcomes were analyzed. The functional outcomes were assessed using the Fingertip Injuries Outcome Score. RESULTS: A total of 30 patients underwent distal fingertip replantation without heparin during the study period. The mean age was 31 years (range, 8-56 years). Machine cut avulsion (23 cases) was the common injury. The mean ischemia time was 7.4 hours. Twenty-five distal replants survived. Fingertip Injuries Outcome Scores categorized outcomes as excellent (n = 10), good (n = 10), fair (n = 5), and poor (n = 5). Complications included shortening (n = 5), nail dystrophy (n = 1), and cold intolerance (n = 1). CONCLUSION: This study suggests favorable functional outcomes for distal fingertip replants without heparin. No significant complications were observed, suggesting that heparin may not be necessary for all cases. Further research is needed for more explicit guidelines on heparin use in fingertip replantation. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.