End to side nerve repair in avulsion amputations

Abstract

In avulsion amputations, replantation is challenging because the structures, such as the skin, veins, nerves, and tendons are extensively damaged. Various techniques have been described for avulsion amputations with nerve defects. If the nerve is avulsed from the main body and the proximal nerve stump cannot be located, nerve transfers, neurovascular island flaps, or end-to-side (ETS) nerve repair are reasonable options. ETS nerve repair involves the coaptation of the distal stump of the transected nerve to the side of the donor nerve. ETS nerve repair has been described as an alternative technique in cases where the proximal nerve stump cannot be located, but literature regarding the use of this technique in avulsion amputations is extremely limited. In this study, we performed replantation in three patients with avulsion amputa- tions of nine digits. We present the long-term outcomes of these nerve repair procedures in this stu