Psychiatric Morbidity After Digital Replantation Versus Amputation

Area of Science:

• Orthopedic Surgery
• Psychiatry
• Health Outcomes Research

Background:

• Psychological distress is common after digital injuries.
• Outcomes vary between digital amputation and replantation.
• Replantation success may influence psychological well-being.

Purpose of the Study:

• Compare psychological outcomes after digital amputation versus replantation.
• Evaluate differences between successful and failed digital replantation.
• Assess incidence of psychiatric diagnoses and medication use post-surgery.

Main Methods:

• Retrospective cohort study using TriNetX database.
• Identified patients undergoing primary digital amputation, successful replantation, or failed replantation.
• Analyzed new psychiatric diagnoses and psychotropic medication prescriptions within 3 years.

Main Results:

• Replantation patients had significantly lower rates of depression, anxiety, and substance abuse than amputation patients.
• Incidence of depression, anxiety, and substance abuse was similar between successful and failed replantation groups.
• Post-traumatic stress disorder (PTSD) rates were higher in failed replantation compared to successful replantation.

Conclusions:

• Digital replantation surgery is associated with better psychological outcomes than amputation, irrespective of success.
• Lower rates of depression, anxiety, and substance abuse observed in replantation patients.
• Findings are significant given the declining trend in hand surgery replantation attempts.