TRANSARTICULAR DIGITAL JOINT AMPUTATIONS: PRESERVATION OF THE ARTICULAR CARTILAGE

of the articular cartilage following digital amputations i a source of infection, delayed healing and eventual stump pain. The Committee for Trauma of the American College of Surgeons advises the removal of articular cartilage when amputating through a digital joint (1972). Contrary to this view, the authors (1972) have attempted to preserve the articular cartilage in a digit whenever feasible. METHOD Since 1965 all digital amputations in patients which have involved the joint of a phalanx have been closed by the authors without removing the articular cartilage (Fig. 1). Local flaps, advancement flaps and combination of flaps and free grafts have been used to close the wounds. In the majority of patients the closure of finger amputations lay over bone because of the level of their injuries. Not all the patients were available for follow-up assessment. Many had been transient workers or indigents who failed to return. Twenty-nine patients with amputations through a digital joint with preservaion of the cartilage have been re-examined. The follow-up period was from three months to three years. These patients had a total of thirty-one transarticular mputations. X-rays taken three or more months after injury were available for fifteen patients. Fourteen of these twenty-nine people had additional partial digital amputations which went through the shafts of phalanges and did not involve a joint (Fig. 2). Seven other patients had amputations through a joint because of gangrene or infection within the finge