Case One

Summary: A 25-year-old male fell off a ladder sustaining a ring avulsion injury beginning at the junction of the distal one-third, proximal two-thirds level of the proximal phalanx.

Following failed venous reconstruction with vein grafts, leeches were applied and color improved dramatically. Application continued every 4 to 6 hours. 5 days postoperatively, active range of motion was begun. 8 days postoperatively, venous flow was sufficiently restored.

3 weeks postoperatively, a skin graft was performed. 6 weeks postoperatively, following treatment with active and passive movement as well as coban taping, the finger has a TAM of 224 degrees.

Procedure illustrated in case one was performed successfully by Dr. D.H. Lalonde, B.Sc, M.Sc.,M.D., FRCSC Plastic and Reconstructive Surgery, St.John, N.B., Canada.

Case 2