The Comparison of Survival Rate in the Proximal or Distal to the Distal Interphalangeal Joint through Clinical Evaluation of Hand Injuries: The Analysis of 230 Finger Replantations

ABSTRACT

To analyze and compare with survival rate of replantation according to each finger and distal interphalangeal joint, we reviewed 230 digital replantation of proximal or distal to the distal interphalangeal joint in 170 patients. From July 1996 to March 1998, 230 digits in 170 patients with complete or incomplete amputations in the proximal or distal to the distal interphalangeal joint were replanted using a microsurgical technique at Jung-ang Gil Medical Center, Gachon Medical School. We classified the finger amputations according to distal interphalangeal joint. As reference line, that is, proximal and distal to DIP joint though many classifications had been proposed. The overall survival rate was 71%, with the survival rates for proximal were 69%, 70%, 65%, 89%, 76%, in order from thumb to little finger and that for distal being 63%, 74%, 59%, 82%, 67%,respectively. The survival rates for proximal replantation were higher than in distal replantation of all digits except index finger, and that was higher in incomplete type injury(76%) than in complete(67%). But there was no statistically significant difference in survival rates for proximal or distal level. Although the technique of tinger replantation was difficult, it was worth attempting to try replantation in any level of amputation because of superiority in the aesthetic and functional result.