Ray Resections of the Fingers: Indications, Techniques, and Outcomes

Ray resection, which was pioneered by Bunnell in the 1920s, was initially performed as a salvage procedure for dysfunction of the proximal interphalangeal joint. Successful ray resection with or without an adjacent ray transfer can be useful for treating vascular insufficiency, tumors, infection, trauma, recurrent Dupuytren contracture, and congenital abnormalities of the hand. Indications, techniques, and outcomes vary based on the digit and the number of digits resected. Compared with amputation at the proximal phalangeal level, a single ray resection has better cosmesis and similar function, resulting in improved patient satisfaction. However, a 15% to 30% loss in grip and pinch strength has been reported. Today, ray resection results in good cosmetic and functional outcomes when preservation of a functional digit is unattainable or when the presence of an abnormal, unreconstructable digit interferes with the overall hand function.