A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers
Kaan Gürbüz1,2
, Yalçın Yontar3,4
1Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Kayseri, Turkey
2Department of Orthopedics and Traumatology, Kayseri City Training and Research Hospital, Kayseri, Turkey
3Department of Plastic Reconstructive and Aesthetic Surgery, Kayseri Training and Research Hospital, Kayseri, Turkey
4Department of Plastic Reconstructive and Aesthetic Surgery, Acıbadem Hospital, Kayseri, Turkey
Keywords: Community hospital, digit, predictors of survival, replantation
Abstract
Objectives: This study aims to evaluate the clinical results and experiences in a community hospital regarding procedures for the replantation and revascularization of fingers.
Patients and methods: Between June 2015 and December 2019, a total of 58 patients (51 males, 7 females; mean age: 33.4±6.3 years; range, 23 to 46 years) who were followed after total and/or subtotal amputation and replantation were retrospectively analyzed. The patients were evaluated at nine months in terms of cold intolerance, static two-point discrimination, and functional results using the range of motion (ROM) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire.
Results: The majority of the patients presented with work-related injuries (70%), most commonly by the mechanism of guillotine (64%), and to the dominant hand (76%) and the third finger (36%) most frequently. The overall success rate of digit salvage was 72.9% (n=51). Of 19 digits with unsuccessful surgical outcomes, seven were from total and 12 were from subtotal amputations. In the long-term, cold intolerance was observed in 14 patients (24.1%) according to the cold intolerance severity scale. The mean static two-point discrimination value was 6.0±0.7 mm and the mean QuickDASH score was 22.3±5.0. The mean ROM measured at nine months after surgery in the metacarpophalangeal and interphalangeal joints of the third and fourth digits was significantly lower than that in the others (p<0.05).
Conclusion: The predictors of survival of a replanted digit indicated in this study can be used as a guide and decision-making aid for any attempts for replantation.
Citation: Gürbüz K, Yontar Y. A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers. Jt Dis Relat Surg 2021;32(2):383-390.
Presented at the International Occupational Accidents, Hand Injuries and Amputations Congress, April 26-27, 2019, Istanbul, Turkey.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.