Importance of the Ribbon Sign, Indicating Unsuitability of the Vessel, in Replanting a Finger

The amputated hand or digit can often be replanted, with useful function restored following replantation.1–11 The criteria determining what injuries should be replanted or revascularized are changing. Early on, only sharply amputated members were felt to be replantable, but now crushed amputations are also candidates for replantation.4–11 The “red line” sign,4 indicative of a severe shearing force along the neurovascular bundle (Fig. 1), is the hallmark of a severe avulsion injury not suitable for replantation. Another sign of avulsion injury, but indicating an injury less severe than those associated with the “red line” sign, will be described—and a method for management will be suggested.