Digital sensibility following replantation

Area of Science:

• Microsurgery
• Reconstructive Surgery
• Peripheral Nerve Repair

Background:

• Amputated digits provide a clear model for studying digital nerve repair.
• Assessing sensory recovery after digit replantation is crucial for functional outcomes.

Purpose of the Study:

• To evaluate sensory recovery in replanted digits.
• To identify factors influencing sensation and cold intolerance after digit replantation.

Main Methods:

• Evaluation of sensibility in 35 replanted digits across 29 patients.
• Assessment of digital vascularity using Allen test, pulse volume flow, and Doppler.
• Analysis of amputation level, injury mechanism, and patient age as influencing factors.

Main Results:

• Sensory return strongly correlated with restored digital vascularity.
• Cold intolerance was universal, with severity proportional to vascularity.
• Adequate contralateral blood flow compensated for single digital artery thrombosis.
• Two-point discrimination was inferior to non-amputated digit nerve repairs.

Conclusions:

• Establishing and maintaining adequate digital blood flow during replantation is essential for good sensation.
• Optimizing vascularity minimizes disabling cold intolerance after digit replantation.
• Digital nerve repair outcomes in replanted digits are influenced by vascularity, injury, and patient factors.