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Current indications for single digit replantation
P N Soucacos1, A E Beris, A S Touliatos
1Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Greece.
Acta Orthopaedica Scandinavica. Supplementum
|June 1, 1995
Summary
Replanted single digits (excluding thumb) show outcomes depend on amputation level. While survival is higher for incomplete amputations, functional use is similar across both types, guiding future replantation indications.
Area of Science:
- Orthopedic Surgery
- Reconstructive Microsurgery
- Hand Surgery
Background:
- Replantation of single digits is a complex procedure with variable functional outcomes.
- Understanding the impact of amputation level on functional results is crucial for surgical decision-making.
Purpose of the Study:
- To investigate the relationship between the level of single digit amputation and functional outcomes after replantation.
- To establish clear indications for single digit replantation based on amputation characteristics.
Main Methods:
- Retrospective analysis of 67 successfully replanted single digits (excluding thumbs).
- Categorization into complete (31) and incomplete nonviable amputations (36).
- Evaluation of functional outcomes, focusing on range of motion at proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints.
Main Results:
- Survival rates were higher for incomplete (89%) versus complete (81%) nonviable amputations.
- Functional digit use was similar between complete and incomplete amputation groups.
- Amputations at the proximal phalanx or proximal interphalangeal (PIP) joint level significantly limited PIP and distal interphalangeal (DIP) joint motion.
Conclusions:
- Functional outcomes of single digit replantation are strongly correlated with the amputation level.
- Recommended indications for replantation include amputations distal to flexor digitorum sublimis insertion, ring injuries (Type II and IIIa), and amputations at or distal to the DIP joint.