Long-term functional results of digital replantation: A survey of 28 patients

We sought to evaluate the long-term quality of life and functional outcome of patients who underwent digital replantation after amputation. A retrospective single-center study was conducted of patients treated between January 2010 to May 2016. Twenty-eight patients who underwent successful replantation after single or multiple digital amputation were reviewed in person after at least 2years' follow-up (mean 4.6years). Total active range of motion, grip and pinch strength were assessed. Functional outcomes were evaluated using the SF-36 and DASH questionnaires. The patients' occupational status and daily activities were reported. Mean total active range of motion was 42% of the contralateral healthy side. Better active mobility and higher grip strength were found when the amputation was distal to the insertion of the common flexor tendon. Mean grip and pinch strength were 80% and 65%, respectively. Fusion did not significantly influence active mobility. The mean DASH score was 22.3. In our study, 77% of the patients returned to the same job and 75% experienced cold intolerance. The majority of patients who underwent digital replantation maintain a quality of life that allows them to return to work. Fusion, especially in the thumb, can be performed with few functional consequences. Even many years after the replantation procedure, sensory recovery remains poor.