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The Aesthetics of Digit Amputation
John Collar1, John Smetona1, Jingwen Zhang2
1Yale University School of Medicine, Section of Plastic Surgery, New Haven, CT, USA.
Hand (New York, N.Y.)
|February 17, 2022
Summary
Aesthetic preferences for digit amputation reveal distal interphalangeal (DIP) joint amputation is favored. Ray amputation is also preferred over proximal interphalangeal (PIP) or metacarpophalangeal (MCP) joint amputations for better aesthetic outcomes.
Area of Science:
- Plastic surgery
- Hand surgery
- Aesthetic research
Background:
- Restoring hand function is the primary surgical goal for traumatized hands.
- Aesthetic considerations significantly impact patient psychological well-being.
- Established biomechanical ideals for hand function post-amputation exist, but aesthetic preferences are undefined.
Purpose of the Study:
- To determine general population aesthetic preferences for various digit amputation levels.
- To provide aesthetic guidance for surgical amputation decisions when function is comparable.
Main Methods:
- Survey of 310 participants assessing aesthetic preferences for single digit amputations.
- Digital manipulation of normal hand images to simulate amputations at DIP, PIP, MCP joints, and ray amputations.
- Rank-order comparison of simulated amputation aesthetics from dorsal and volar views.
Main Results:
- Amputation at the distal interphalangeal (DIP) joint was the most favored aesthetic outcome.
- Ray amputation ranked second most aesthetic, particularly for middle and ring fingers, surpassing PIP joint amputations.
- Aesthetic preference varied by digit and amputation level.
Conclusions:
- Aesthetic outcomes should be a consideration in amputation level selection when functionality is equivocal.
- DIP joint amputation is generally preferred for aesthetic results.
- Ray amputation offers superior aesthetics compared to PIP or MCP joint amputations for most digits.
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