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Thumb amputations from team roping.
Moheb S Moneim1, Keikhosrow Firoozbakhsh, Dominic Gross
1Department of Orthopaedics and Rehabilitation, School of Medicine, University of New Mexico, Albuquerque, New Mexico 87131, USA.
The American Journal of Sports Medicine
|September 17, 2003
Summary
Thumb replantation after team roping injuries has a low success rate, especially in adults. Despite poor outcomes, patients reported satisfaction, with some returning to rodeo activities.
Area of Science:
- Orthopedic surgery
- Microsurgery
- Trauma surgery
Background:
- Thumb injuries in team roping often involve avulsion and crush mechanisms.
- These injuries present a poor prognosis for successful thumb replantation.
Purpose of the Study:
- To review 19 cases of thumb amputation resulting from team roping.
- To analyze the outcomes of thumb replantation attempts in this specific patient cohort.
Main Methods:
- Retrospective cohort study of 19 thumb amputation cases.
- Inclusion criteria required microvascular repair for thumb survival; vein grafts were utilized.
- 15 replantation attempts were made; four cases involved bone shortening and primary closure.
Main Results:
- Only 5 of 15 (33%) thumb replantation attempts were successful.
- Younger patients (<15 years) had a higher success rate (60%) compared to older patients (20%).
- Intraoperative poor blood flow was a significant factor in failed replantations.
Conclusions:
- Despite a low overall success rate, patients reported subjective satisfaction with outcomes.
- Successful replants and even some non-replanted cases allowed return to rodeo activities.
- The immense force exerted during team roping injuries contributes to poor replantation prognosis.