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January 1965

Correction of Digital Ischemia By Arterial Transfer: A New Indication for the Neurovascular Island Transfer

Author Affiliations

From the Hand Service, Boston City Hospital.; Attending surgeon, Hand Services, Boston City Hospital, Boston Veteran's Hospital, and St. Elizabeth's Hospital, Brighton, Mass, Sr. Clinical Instructor in Surgery, Tufts University Medical School, Boston.

Arch Surg. 1965;90(1):139-142. doi:10.1001/archsurg.1965.01320070141030

IN 1764, TISSOT published his translation of Bilguer's Dissertation sur l'inutilité de l'amputation des membres (Fig 1) in which Bilguer condemned the indiscriminate amputation of limbs on the battlefield for gunshot wounds, arterial injuries, open fractures, and loss of soft tissues. He believed that the limbs of many of the soldiers would survive and spare these individuals the socioeconomic stigmata of the amputee.

This presentation represents an extension of Bilguer's conservative thinking, since a viable major index finger has been salvaged and improved to a significant degree after the traumatic division of both neurovascular bundles, the flexor tendons, and comminution of the proximal phalanx.

A digit may survive after the division of both digital arteries as in a near amputation if the remaining bridge of tissue contains sufficient radicles of the dorsal metacarpal arteries. Rarely, finger survival has been reported after replacement following complete severance. In either case blood flow

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