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Distal and very distal digital replantations
1SOS Main Strasbourg, France.
British Journal of Plastic Surgery
|April 1, 1992
Summary
Digital replantation surgery offers good outcomes for amputated digits, even without vein repair. However, smoking significantly reduces success rates, while the procedure requires a mean of 74 days off work.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Digit amputations present unique surgical challenges, particularly in Zone III distal to the nail matrix.
- Specialized techniques are required for artery, nerve, and vein repair in distal digit injuries.
Purpose of the Study:
- To evaluate the outcomes of distal digit replantation.
- To assess the impact of vein repair absence and smoking on replantation success.
Main Methods:
- Review of 95 patients with 98 complete or incomplete digit amputations.
- Classification of amputation levels based on bony lesion, focusing on Zone III.
- Analysis of outcomes including survival rate, sensibility, and functional recovery.
Main Results:
- Overall survival rate for digit replantation was 65.5%.
- Replantation survival rate was 68% even without vein repair, utilizing leeches.
- Smoking significantly decreased survival rate to 52%.
- Distal replantation provided acceptable sensibility, no proximal interphalangeal (PIP) joint limitation, and good appearance.
- Patients required a mean of 74 days off work.
Conclusions:
- Distal digit replantation is a viable and beneficial procedure.
- Leech therapy can be an acceptable alternative in cases where vein repair is not feasible.
- Smoking is a significant negative prognostic factor for digit replantation survival.