Hongyi Zhu1,2, Bingbo Bao1,2, Xianyou Zheng1,2. 1. Shanghai, People's Republic of China. 2. From the Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People's Hospital.
Abstract
BACKGROUND: The functional outcomes and therapeutic costs between digit replantation and revision amputation have remained controversial. METHODS: A total of 1023 patients with single-digit traumatic amputation or devascularization who underwent successful digit replantation (failure excluded) or revision amputation from January 1, 2013, to January 1, 2016, were included in this study. All cases were subgrouped based on Tamai level of amputation and the injured digit. The clinical outcomes were assessed using the Michigan Hand Outcomes Questionnaire 1 year after the initial operation. The authors also compared the cost of treatment, the duration of hospitalization, and the duration of sick leave between the two treatments. RESULTS: Replantation of small (level I to V), ring (level I to III), and long (level I) fingers showed no functional benefit compared with initial revision amputation. In contrast, replantation of thumb (level I to V), index (level I to V), long (level II to V), and ring (level IV to V) fingers had better outcomes. The cost of replantation was higher and the durations of hospitalization and sick leave of replantation were also longer compared with the revision amputation group. CONCLUSIONS: Single amputated injuries of small (level I to V), ring (level I to III), and long (level I) fingers are a relative contradiction for replantation. Replantation of thumb (level I to V), index (level I to V), long (level II to V), and ring (level IV to V) fingers showed extra benefit compared with revision amputation.
BACKGROUND: The functional outcomes and therapeutic costs between digit replantation and revision amputation have remained controversial. METHODS: A total of 1023 patients with single-digit traumatic amputation or devascularization who underwent successful digit replantation (failure excluded) or revision amputation from January 1, 2013, to January 1, 2016, were included in this study. All cases were subgrouped based on Tamai level of amputation and the injured digit. The clinical outcomes were assessed using the Michigan Hand Outcomes Questionnaire 1 year after the initial operation. The authors also compared the cost of treatment, the duration of hospitalization, and the duration of sick leave between the two treatments. RESULTS: Replantation of small (level I to V), ring (level I to III), and long (level I) fingers showed no functional benefit compared with initial revision amputation. In contrast, replantation of thumb (level I to V), index (level I to V), long (level II to V), and ring (level IV to V) fingers had better outcomes. The cost of replantation was higher and the durations of hospitalization and sick leave of replantation were also longer compared with the revision amputation group. CONCLUSIONS: Single amputated injuries of small (level I to V), ring (level I to III), and long (level I) fingers are a relative contradiction for replantation. Replantation of thumb (level I to V), index (level I to V), long (level II to V), and ring (level IV to V) fingers showed extra benefit compared with revision amputation.
Authors: Syena Moltaji; Matteo Gallo; Chloe Wong; Jessica Murphy; Lucas Gallo; Daniel Waltho; Andrea Copeland; Marta Karpinski; Sadek Mowakket; Eric Duku; Achilleas Thoma Journal: J Hand Microsurg Date: 2020-04-09
Authors: Kayla R Rizzo; Michael D Eckhoff; Gilberto A Gonzalez; Shawn Diamond; Leon Nesti; John C Dunn Journal: Plast Reconstr Surg Glob Open Date: 2022-09-14