Reconstructive surgery of the amputated ring finger

Area of Science:

• Orthopedic surgery
• Hand surgery
• Reconstructive surgery

Background:

• Loss of a fourth digit compromises hand grip and skilled movements, often leading to stump trauma.
• Digital ray amputation is a less common procedure, but can significantly enhance hand function and cosmesis.
• Fifth digital ray transposition can close the gap from a missing digit, improving overall hand appearance.

Purpose of the Study:

• To evaluate the functional and aesthetic outcomes of fifth ray radial translation and intercarpal arthrodesis.
• To assess the efficacy of this procedure in managing mutilating ring finger injuries.

Main Methods:

• Retrospective study of nine patients with mutilating ring finger injuries.
• Patients underwent delayed fourth ray amputation with fifth ray transposition (mean 14 days post-injury).
• Mean follow-up period was 17.1 months; grip strength and RAS scores were assessed.

Main Results:

• Significant improvements in grip strength and hand function (RAS score) were observed post-surgery.
• Hand dominance did not negatively impact postoperative grip strength or RAS scores.
• The procedure was technically feasible and associated with fewer complications than alternative methods.

Conclusions:

• Resection of the fourth ray with fifth finger transposition and hamate-capitate arthrodesis is technically simpler than metacarpal osteotomy.
• This surgical approach effectively restores both hand function and cosmetic appearance in patients with severe ring finger injuries.
• The technique offers a valuable reconstructive option for mutilating ring finger trauma.