The palmar digital veins run alongside the palmar digital arteries, draining the pulp and palmar skin of the fingers into the superficial palmar venous arch. They are valved in the proximal direction. In finger replantation, at least one digital vein must be repaired to allow venous outflow; when palmar veins are not repairable, dorsal digital veins are used.
Palmar digital vein repair is essential in finger replantation and revascularisation. At least two veins should be repaired for optimal venous drainage. When the palmar digital veins are damaged beyond repair, dorsal digital veins are dissected and transposed to the palmar surface. Failure to establish adequate venous outflow in replantation produces venous congestion and eventual replant failure. The palmar digital veins are also relevant in vascular malformations of the finger pulp.
After digital artery anastomosis in finger replantation, at least one but ideally two palmar digital veins must be repaired to prevent venous congestion; when both palmar digital veins are avulsed, the dorsal digital veins are dissected and brought to the palmar aspect through subcutaneous tunnels for anastomosis.
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