Secondary surgery after digit replantation: its incidence and sequence

This article discusses the incidence and sequence of secondary procedures following digital replantation. In published series addressing this topic, the overall frequency of postreplantation surgery ranged from 2.9-93.2%. Tendon procedures accounted for 47.2% of cases, and comprised the leading type of secondary operations. Tendon procedures were followed by joint procedures (18.9%), skeletal stabilization (12%), skin coverage (11.4%), nerve reconstruction (8.9%), and late amputation (1.6%). The number of secondary procedures per patient averaged from 1-4.5, depending on prioritization of different procedures. The order of restoration procedures should be as follows: supple skin coverage, skeletal stability, and protective and proprioceptive sensation. Joint reconstruction follows these procedures, which in turn is followed by tendon reconstruction.