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Related Experiment Videos

Rotating shaft avulsion amputations of the thumb.

C V Bowen1, J Beveridge, R G Milliken

  • 1Department of Orthopaedic Surgery, University Hospital, Saskatoon, Saskatchewan, Canada.

The Journal of Hand Surgery
|January 1, 1991
PubMed
Summary

Thumb replantation for rotating shaft avulsion amputations can achieve good functional outcomes. Early staged procedures showed success, leading to a shift towards single-stage reconstructions for better thumb function.

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Area of Science:

  • Hand surgery
  • Microsurgery
  • Reconstructive surgery

Background:

  • Rotating shaft avulsion amputations of the thumb present unique reconstructive challenges.
  • Concerns regarding low survival rates historically led to staged surgical approaches.

Purpose of the Study:

  • To evaluate the outcomes of thumb replantation using a staged approach for rotating shaft avulsion amputations.
  • To assess functional recovery, including grip strength, pinch, and sensory discrimination.

Main Methods:

  • A retrospective review of 29 patients treated for thumb avulsion amputations over three years.
  • Twenty-three suitable thumbs underwent primary replantation followed by secondary nerve grafting and tendon reconstruction.
  • Functional outcomes were assessed at a mean follow-up of 20.5 months.

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Main Results:

  • Nineteen of twenty-three replanted thumbs survived.
  • Achieved mean grip strength was 94.6% and key pinch was 77.1% of the unaffected side.
  • Five patients demonstrated two-point discrimination of less than five millimeters.

Conclusions:

  • A staged approach to thumb replantation for rotating shaft avulsion amputations can yield successful survival and functional recovery.
  • The positive outcomes observed have informed a shift towards performing full reconstructions in a single-stage procedure.