Clinical replantation of digits and its problem

Abstract

571 replanted digits in 395 patients were critically evaluated from the point of view of the surgical technique, level of amputation, post-operative complications and the eventual functional end result. When the period of ischaemia exceeded 10 hours, the risk of failure was higher. Bone union was delayed in the digits in which the period of ischaemia was longer than 5 hours. Single thumb and multiple finger amputations were functionally most useful regardless of the level of amputation, the range of mobility or the sensory recovery. Single finger replantations resulted in poor function especially for the index and little finger. Replantation of a single finger amputation is of questionable value from the point of view of time spent both by the surgeon and the patient. Surprisingly, replantations for amputation proximal to the proximal interphalangeal joint produced much less satisfactory functional result as compared to those for amputations distal to this joint.