[Hand replantation: long-term functional results (apropos of 8 cases)]

Abstract

Study aim: The aim of this study was to report the long term functional results after replantation of the hand in eight patients.

Materials and methods: Between 1977 and 1995, hand replantation was performed in eight cases (six males and two females). Mean age at the time of injury was 31 years (24-47 years). The dominant hand was amputated in half of the cases. In two cases, the soft tissue lesions were severe; in the six other cases, the wound was clean-cut. The level of amputation was transmetacarpal (n = 2), carpal (n = 2), wrist (n = 2), distal part of the forearm (n = 2).

Results: The mean convalescence time was 16 months (from 6 months to 2 years). The degree of disability ranged from 40 to 65%. Patient follow-up lasted 2 to 20 years (mean: 11 years). The return of discriminative sensitivity of the digits was noted in six cases. The active motion of the fingers was satisfactory in all cases, but intrinsic muscle function was weak or absent. Pinch and grasp strength was reduced from 10 to 60% (when compared to the non-damaged hand). One patient resumed his prior occupation, and another resumed his occupation part-time. The six other patients found new occupations.

Conclusion: All the patients achieved a useful function of their replanted hand in their daily, spare-time and professional activities.