Digital avulsion injuries: epidemiology and factors influencing finger preservation
Retrospective study published in Arch Orthop Trauma Surg (2020)
Abstract
INTRODUCTION: The surgical treatment of ring avulsion injuries is still challenging. This study provides data concerning epidemiology and factors influencing finger survival rate. We wanted to answer the question whether microsurgical advancement and a high level of surgical expertise nowadays may improve the outcome. PATIENTS AND METHODS: Between 11/2007 and 06/2016 95 ring avulsions were treated (classified according to Kay). Complete documentation was available from 87 patients (25 female). The mean age was 34 (4-82) years. Intact perfusion (Kay I) was preoperatively seen in 20 fingers while 67 were avascular (Kay II-IV). RESULTS: In 89%, the ring finger was injured during mainly private accidents. Primary amputation was performed in 38 Kay II-IV injuries. Revascularization was applied to 29 fingers while 8 of them (28%) primarily failed. After initially successful revascularization/replantation of 21 fingers, 6 had to be amputated secondarily (success rate: 52%). There was no significant correlation between affected finger and rate of finger preservation. Climbing over a fence as trauma mechanism significantly correlated with lower finger preservation rates and higher incidence of Kay IV injuries. CONCLUSION: Despite microsurgical advances and high levels of surgical expertise the finger survival rate after ring avulsion injuries still seems to be mostly influenced by the extend of intrinsic damage.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Single-center 9-year analysis of 95 ring avulsions showing 52% overall success rate. Climbing-over-fence mechanism associated with lower finger preservation.
Warum dies für die Hirudotherapie relevant ist
This study analyzed 95 ring avulsion injuries (87 with complete documentation) treated between 2007 and 2016, classifying them by Kay classification and examining factors influencing finger preservation rates, including trauma mechanism and microsurgical revascularization outcomes. The authors found that despite microsurgical advances, finger survival was primarily determined by the extent of intrinsic damage, with climbing over a fence correlating with poorer preservation rates. The abstract contains no mention of leeches, hirudotherapy, or leech-derived therapies. While leech therapy is sometimes used adjunctively in digital replantation for venous congestion, this study does not address that application, and there is no defensible leech-related relevance based on the abstract alone.
Zitation
Digital avulsion injuries: epidemiology and factors influencing finger preservation.
Struckmann VF et al. · Archives of orthopaedic and trauma surgery, 2020
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