Tendon function after replantation of complete thumb avulsion amputations

Area of Science:

• Orthopedic surgery
• Hand surgery
• Reconstructive surgery

Background:

• Tendon avulsion at the musculotendinous junction from digit amputation presents significant reconstructive challenges.
• Complete thumb avulsion amputations require effective tendon repair strategies for optimal functional recovery.

Purpose of the Study:

• To compare functional tendon outcomes between two surgical methods for thumb avulsion amputations.
• Evaluate reattachment to muscle versus tendon transfer for musculotendinous junction avulsion rupture.

Main Methods:

• Retrospective study of patients with complete thumb avulsion amputations (July 2008-October 2019).
• Comparison of tendon repair via reattachment to muscle (Group I) and tendon transfer (Group II).
• Outcomes assessed included range of motion, pinch strength, grip strength, and reoperation rates.

Main Results:

• 23 patients with a mean follow-up of 16.6 months were analyzed.
• Pinch strength was significantly higher in the tendon transfer group (Group II) compared to the reattachment group (Group I) (P = 0.001).
• Total active range of motion (P = 0.095) and grip strength (P = 0.075) were comparable; reoperation rates showed no significant difference (P > 0.05).

Conclusions:

• Tendon transfer is superior in achieving higher pinch strength for thumb avulsion amputations.
• This technique is recommended for patients whose occupations demand significant hand strength.