Functional Outcome in Digital Replantations – A Study Over A Period of 5 Years

ABSTRACT

Introduction: Replantation should be the prime indicationsfor treatment of amputated fingers, due to functional andaesthetic advantages. Study aimed to evaluate not study thefunctional outcome of digital replantation over a period of 5years.Material and methods: Seventy four digital replantationswere carried out since June 2013 till May 2018. Mechanism ofinjury was sharp in 36 digits, crush in 18 digits, avulsion in 14digits and blast injury accounted for 6 digits. The distributionof replanted digits was 38 thumbs, 22 index fingers, 9 middlefingers and 5 ring fingers. In 18 patients multiple digits werereplanted. Eleven digits required reexploration and two digitswere reexplored thrice.Results: We had 62 successful replantations with 12 failures.18 digits had good functional recovery, 30 satisfactoryrecovery and 14 poor function. The subjective satisfactionscore was calculated by the DASH score.Conclusion: Replantation surgery have become the method ofchoice in treating the digit amputations with the developmentof microscope. The viability of the replanted part is guaranteedby a successful vessel anastomosis, while the quality ofthe bone, tendon, nerve, and skin repair will determine theoverall functional success of the replanted parts. Repair ofall structures at the time of the primary procedure should beattempted, as secondary surgery is technically difficult