A retrospective study of functional outcomes after successful replantation versus amputation closure for single fingertip amputations

被引:126
|
作者
Hattori, Yasunori
Doi, Kazuteru
Ikeda, Keisuke
Estrella, Emmanuel P.
机构
[1] Ogori Daiichi Gen Hosp, Dept Orthoped Surg, Yamaguchi, Yamaguchi Pref 7540002, Japan
[2] Yamaguchi Univ, Sch Med, Yamaguchi 753, Japan
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2006年 / 31A卷 / 05期
关键词
fingertip amputation; replantation; amputation closure;
D O I
10.1016/j.jhsa.2006.02.020
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: To compare the functional outcome of successful microsurgical replantation versus amputation closure for single fingertip amputations. Methods: Forty-six fingertip amputations in 46 patients (23 were replanted successfully, 23 had amputation closure) were included in this study. Thumb amputations were excluded. Grip strength and active range of motion of the proximal interphalangeal joint were evaluated. The patients were questioned about their symptoms of pain, paresthesia, and cold intolerance. The Disabilities of the Arm, Shoulder, and Hand questionnaire was given and the disability/symptom score was evaluated. Patients' satisfaction with the surgical result was assessed. Time spent in the hospital and time off from work were reviewed. Results: Active range of motion of the proximal interphalangeal joint was greater in the successful replantation group. Although the existence of paresthesia and cold intolerance were not statistically different between the 2 groups, pain in the affected fingers was more frequent in the amputation closure group. The average Disabilities of the Arm, Shoulder, and Hand score of the successful replantation group was statistically better. All patients in the successful replantation group were highly or fairly satisfied with the surgical results, whereas 14 patients in the amputation closure group were highly or fairly satisfied. The time spent in the hospital and the time off from work for the successful replantation group were longer. Conclusions: Successful replantation of single fingertip amputations can result in minimal pain, better functional outcome, better appearance, and higher patient satisfaction. We recommend attempting fingertip replantation not only to obtain the best appearance but also to gain better functional outcome. if the patient requests the simple surgery and earlier return to work amputation closure is an accepted method despite the disadvantage of digital shortening and the risk for a painful stump.
引用
收藏
页码:811 / 818
页数:8
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