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Hand function after digital amputation

S P Chow1, C Ng

  • 1Hong Kong Society for Surgery of the Hand.

Journal of Hand Surgery (Edinburgh, Scotland)
|February 1, 1993
PubMed
Summary
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Finger and thumb amputations significantly impact hand function long-term, with persistent numbness and reduced grip strength affecting daily activities and employment. Recovery of range of motion is faster than regaining full grip and pinch strength.

Area of Science:

  • Orthopedics
  • Hand Surgery
  • Rehabilitation Medicine

Background:

  • Amputations of the digits, specifically fingers and thumbs, present significant challenges to hand function.
  • Understanding the long-term functional recovery after such injuries is crucial for patient management and rehabilitation.

Purpose of the Study:

  • To evaluate the functional recovery of hand function one year after finger or thumb amputation.
  • To identify factors influencing recovery of range of motion, grip strength, and pinch strength.

Main Methods:

  • A prospective study followed 127 patients with amputated thumbs or fingers (DIP to MP joint level) for one year.
  • Functional outcomes including sensory disturbances, range of motion, power grip, and key pinch were assessed at regular intervals.

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Main Results:

  • While range of motion recovered early, significant deficits in power grip and key pinch (70% recovery) persisted at one year.
  • Numbness remained in 50% of patients at one year.
  • Amputations of multiple digits, the thumb, or the middle finger resulted in the worst power grip outcomes.
  • Key pinch was impaired in almost all patients (50-60% deficit).
  • Job modifications were required for 25% of patients, and 20% expressed cosmetic concerns.

Conclusions:

  • Functional recovery after finger and thumb amputation is incomplete at one year, particularly concerning grip and pinch strength.
  • Specific amputation levels and the number of digits affected significantly influence functional deficits.
  • The long-term functional and psychosocial impact necessitates comprehensive rehabilitation strategies.