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Replantation in children.

J S Taras1, J A Nunley, J R Urbaniak

  • 1Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC 27710.

Microsurgery
|January 1, 1991
PubMed
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Pediatric digital replantation is recommended for all traumatic amputations in children, offering a 77% survival rate. Successful replantation ensures continued skeletal growth and high patient satisfaction.

Area of Science:

  • Pediatric surgery
  • Hand surgery
  • Microsurgery

Background:

  • Traumatic amputations in children require specialized consideration for replantation.
  • Previous studies have not fully elucidated the long-term outcomes of pediatric digital replantation.

Purpose of the Study:

  • To evaluate the outcomes of digital replantation in pediatric patients.
  • To assess the survival rates, functional recovery, and patient satisfaction following pediatric digital replantation.

Main Methods:

  • Retrospective review of 162 digital replantations in 120 children over 15 years.
  • Surgical technique emphasized minimal bone shortening to preserve epiphyseal plates and repair of all severed structures.
  • Fixation was typically achieved with longitudinal K-wires.

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Main Results:

  • A 77% survival rate for complete digital replantation in patients under 16 years.
  • Replanted digits achieved 81% of normal longitudinal length at maturity, with continued skeletal growth.
  • Sensory recovery was comparable to isolated digital nerve repairs, and patient/parent satisfaction was high.

Conclusions:

  • Digital replantation is a viable and beneficial option for children with traumatic amputations.
  • The procedure promotes functional and skeletal recovery, leading to high levels of patient and parental satisfaction.
  • Pediatric digital replantation should be strongly considered in cases of traumatic amputation.