Long-term clinical results of 33 thumb replantations
Research article published in Injury (2020)
Abstract
INTRODUCTION: Thumb replantation following complete amputation is a relatively frequent and well-established surgical procedure. In literature many studies report a discrepancy between the objective measurements and the subjective satisfaction of the patients. Nowadays, evaluation of the patient long-term benefit obtained by replantation is uncertain. The aim of this study was to consider the long-term results of 33 thumb replantation procedures. METHODS: The period considered is from January 1997 to December 2015, 33 subjects fulfilled the study inclusion criteria and were included in the study. We evaluated in each patient: ROM (performing Kapandji test), level and mechanism of amputation, force peak of three grips using Dexter dynamometer (five-handle, key, tri-digital grips), sensibility (using Disk-Criminator and aesthesiometers of Semmes-Weinstein) and subjective perception of disability (using DASH questionnaire). RESULTS: All patients were males, 94% of them returned to their previous occupation. Average follow-up was 9±4 years. The prevalent mechanism of injury was a combined amputation in 58% of cases. Levels involved in more than half of patients were interphalangeal joints and proximal phalanxes. Ratios of strength recovery were: for the five-handle grip equal to 0.90±0.28 kg (p=0.63), 0.78±0.30 kg (p=0.64) for key grip and 0.75±0.32 kg (p=0.78) for tri-digital grip. Results for Kapandji test was 8±2 and for DASH test was 16±21. The protective tactile threshold was recovered in 49% of patients; S2PD test resulted positive in 54% and D2PD test in 39% of cases. CONCLUSIONS: Results confirm and strengthen evidence of positive long-term functional outcomes of thumb replantation interventions.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Thumb replantation following complete amputation is a relatively frequent and well-established surgical procedure.
Warum dies für die Hirudotherapie relevant ist
This study evaluated long-term functional outcomes (average 9±4 years follow-up) in 33 male patients who underwent thumb replantation after complete traumatic amputation, assessing range of motion, grip strength, sensibility, and subjective disability (DASH). Results showed that 94% returned to their previous occupation, with good strength recovery ratios and reasonable sensory recovery, supporting the long-term benefit of thumb replantation. The study does not mention or employ leeches, hirudotherapy, or any leech-derived agents. There is no direct relevance to ASH's domain; the connection is limited to the general surgical context of digital replantation, with no leech-related content or findings.
Zitation
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