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Replantation vs revision amputation in single digit zone II amputations
M El-Diwany1, A Odobescu1, M Bélanger-Douet1
1Plastic and Reconstructive Surgery Service, University of Montreal Hospital Center, Montreal, Canada.
Summary
For zone II single digit amputations, replantation and revision amputation yield similar functional outcomes. Patients undergoing replantation reported higher willingness to repeat the procedure, indicating comparable satisfaction despite longer recovery.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Hand Surgery
Background:
- Zone II single digit amputations present complex treatment decisions.
- Replantation and revision amputation are primary surgical options.
- Patient-reported functional outcomes require comparative analysis.
Purpose of the Study:
- To compare functional outcomes of zone II single digit amputations treated with replantation versus revision amputation.
- To provide data for informed patient decision-making regarding treatment options.
Main Methods:
- Retrospective comparative study of patients with zone II single digit amputations (2007-2011).
- Stratification into replantation (n=17) and revision amputation (n=14) groups.
- Assessment using Quick-DASH, Beck Depression Inventory-short form, and custom questionnaire.
Main Results:
- No statistically significant differences in sick leave, reintegration, discontinued activities, or self-confidence.
- Similar levels of pain, cold intolerance, and global functional/esthetic satisfaction between groups.
- Replantation group showed higher willingness to repeat the procedure; no functional superiority of revision amputation.
Conclusions:
- Revision amputation is not functionally superior to replantation for zone II single digit amputations.
- Functional outcomes are comparable, supporting informed consent discussions.
- Patient willingness to repeat the procedure may indicate underlying satisfaction differences.
