The Experimental Study of the Venous Drainage through theBone Marrow at Replantation of the Amputated Digits and free tissue transfer.

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Venous drainage is an important factor for the success of the replantation of the amputated digits, especially at the level of distal phalanx. However, venous drainage cannot be always reconstructed, because the vein is not searched and is too small to suture etc. In this study, the venous drainage through the bone marrow is seemed to be useful and significant while the new subcutaneous vein.The amputated limbs are observed skin color and the blood flow of them are measured with a laser Doppler flow meter. Dye injection study and radioisotope perfusion study of the bone marrow are perfomed. The groups of the bone marrow with continuity are almost survival. It is suggested that the bone marrow is imporatant for the venous drainage. We have had many clinical cases which been replanted digits amputated at the distal phalanx level and have experienced several successful cases without venous reconstruction. Most of them were excised the distal phalangeal joint cartilage and both of the phalangeal bones were fixed using only single sraight wire with the least damage possible at replantation.There are a few reports which are described significance of the bone marrow for the venous drainage sysytem and there is no report which is investigated experimentally. It was suggested that the bone marrow was imporatant for the venous drainage, especially at the immediately-phase and early-phase after operation until the regeneration of the subcutaneous venous drainage system.