American Society of Hirudotherapy

Complications and Pitfalls after Finger Replantation in Young Children

Research article published in Journal of hand and microsurgery (2018)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportDrug DevelopmentLafosse T et al. · Journal of hand and microsurgery, 2018

Abstract

Study Design This is a retrospective cohort study. Objective The authors report surgical outcome in a series of very young children who underwent finger replantation after traumatic amputation. Methods During a 10-year period, 65 children were treated with replantation for finger amputation in two institutions. This study focused on replantation of 15 fingers in 13 young patients under 6 years of age (mean age: 2.9 years; range: 1.1-5.7 years). Early postoperative complications were categorized into major or minor. At the time of assessment, the authors evaluated everyday life activities, pain and cold tolerance, total active range of motion (TAM) in patients with successful replantation, and growth disturbance. Results The overall success rate for children younger than 6 years was 47% (7 out of 15), and the authors had 67% of major complications, mainly in patients with crush injuries. There was venous ischemia in 13 (86%) fingers treated with controlled bleeding. The hemoglobin level decreased more than 2 g/dL in six patients, and blood transfusion was necessary in two patients. At the last follow-up, patients with successful replantation had a mean TAM of 72%. Conclusion Despite numerous complications mainly in relation with venous congestion, the functional outcome is satisfactory after successful replantation in young children, which should always be attempted. Level of Evidence/Type of Study Level III, case series, therapeutic study.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article

Summary

This is a retrospective cohort study.The authors report surgical outcome in a series of very young children who underwent finger replantation after traumatic amputation.During a 10-year period, 65 children were treated with replantation for finger amputation in two institutions.

Why This Matters for Hirudotherapy

This retrospective cohort study evaluated surgical outcomes and complications in very young children following finger replantation after traumatic amputation. The study reports a high rate of venous ischemia (86%) treated with controlled bleeding, a clinical scenario where medicinal leeches are frequently employed to salvage compromised tissue. However, the abstract does not explicitly state the use of leech therapy. Thus, its relevance to the American Society of Hirudotherapy is limited to the contextual overlap of managing venous congestion in microsurgical replantation.

Citation

Complications and Pitfalls after Finger Replantation in Young Children

Lafosse T et al. · Journal of hand and microsurgery, 2018

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.