Considerations of Differing Levels and Mechanisms of Amputation

Abstract

Zone I: Zone I extends from the finger tip to the root of the nail. Loss of this part does little to impair the basic function of the hand and this is expressed in the attitude of Insurance Companies. Nevertheless, after such an injury, the finger is robbed of its refined sensibility and from an aesthetic point of view there is loss of the nail-bearing segment. Certain occupations, e.g. music-making, are no longer possible. Proximal to the nail bed the veins are formed from the capillary area of the finger pulp so that dorsally no veins suitable for anastomosis are found. Occasionally a volar vein is available. In contrast, the arteries at this level are still well formed and in most cases can be anastomosed. The nerves have already branched out towards their functional end organs.

The classification of the levels of amputation and the mechanisms of amputation conform to the guidelines of the Replantation Committee of the International Society for Reconstructive Microsurgery drawn up at the 5th Symposium in May 1979 in Guaruja, Brazil