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Functional outcome after digit replantation versus amputation.

Sarah M Bott1, Katarzyna Rachunek1, Fabian Medved1

  • 1Department of Hand, Plastic and Reconstructive Surgery, BG Trauma Center, Eberhard-Karls University Tuebingen, Schnarrenbergstr. 95, 72076, Tuebingen, Germany.

Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
|July 27, 2022
PubMed
Summary

Digit replantation offers comparable functional and sensory outcomes to amputation, with significantly reduced pain. This study highlights the benefits of replantation for patients seeking better quality of life after traumatic digit injuries.

Keywords:
AmputationDigitFunctional outcomeReplantationSensitive recovery

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Area of Science:

  • Orthopedic Surgery
  • Microsurgery
  • Trauma Surgery

Background:

  • Digit replantation success is often measured by survival rates.
  • Functional outcomes and sensory recovery are crucial but under-assessed parameters post-replantation.

Purpose of the Study:

  • To compare functional outcomes and sensory recovery between successful digit replantation and primary/secondary amputation.
  • To evaluate pain levels and upper extremity function in both groups.

Main Methods:

  • 48 patients with 56 complete traumatic digit amputations underwent follow-up assessments.
  • Evaluated range of motion, strength, two-point discrimination (2-PD), and Semmes-Weinstein monofilament (SWM) tests.
  • Assessed pain and DASH scores for subjective outcomes.

Main Results:

  • Replanted digits achieved 58% of normal range of motion; grip/pinch strength showed no significant difference compared to amputation.
  • Excellent sensory recovery post-replantation (median 2-PD 5 mm) and good recovery post-amputation (median 2-PD 6 mm).
  • Significantly less pain reported after replantation versus amputation, with no difference in DASH scores.

Conclusions:

  • Digit replantation provides comparable functional and sensory results to amputation.
  • Replantation leads to significantly less pain at rest and under strain compared to amputation.
  • These findings support replantation as a viable option for improving patient outcomes.