To investigate the clinical curative effect and feasibility of two-needle sutures anastomosis of microvessels and micronerves to replant tiny fingertips under suspended two-point support balance.

A retrospective analysis was performed on 26 patients (26 digits) with completely severed ting fingertips who were admitted to the Department of Hand and Foot Microsuegery of Nanjing Jiangbei Hospital from July 2021 to September 2024. Under the balance of suspended two-point support, two points were located at 12 (9) o’clock and 6 (3) o’clock on the ruptured microvessels and micronerves. One needle suture was performed at 12 (9) o’clock, and the other was performed at 6 (3) o’clock. A total of two needle sutures were performed for end-to-end anastomosis of microvessels and micronerves to restore superior digital arch artery and fingertip nerve connection and balance. The ratio of anastomosed vessels and nerves was 1:1. All patients were entered into scheduled follow-ups through a combination of visit of outpatient clinics or WeChat and telephone reviews, and the recovery of finger shape, function, and sensation was recorded. The clinical efficacy was evaluated according to the standard functional evaluation issued by the Hand Surgery Association of Chinese Medical Association.

All 26 ting fingertips survived completely, and the blood circulation of replanted fingertip was stable after operation. No vascular crisis occurred. The follow-up period ranged from 6 to 22 months, with an average of 8.5 months. At the final follow-up, the appearance and functional recovery of replanted fingertips were good, with the appearance being close to that of the contralateral healthy finger. According to the standard functional evaluation issued by the Hand Surgery Association of Chinese Medical Association: the function was excellent in 23 cases and good in 3 cases, with an excellent/good rate of 100%.

Two-needle suture anastomosis of microvessels and micronerves under suspended two-point support balance is an effective method to replant tiny fingertips, and it can achieve sensory recovery, increased survival rate, and good long-term appearance and functional recovery with no vascular crisis.