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.
Resumen
Single-center 9-year analysis of 95 ring avulsions showing 52% overall success rate. Climbing-over-fence mechanism associated with lower finger preservation.
Por qué esto importa para la hirudoterapia
Este estudio analizó 95 lesiones por avulsión anular (87 con documentación completa) tratadas entre 2007 y 2016, clasificándolas según la clasificación de Kay y examinando los factores que influyen en las tasas de preservación del dedo, incluyendo el mecanismo del traumatismo y los desenlaces de la revascularización microquirúrgica. Los autores hallaron que, a pesar de los avances microquirúrgicos, la supervivencia del dedo estuvo determinada principalmente por la extensión del daño intrínseco, y que trepar por una valla se correlacionó con peores tasas de preservación. El resumen no contiene mención alguna de sanguijuelas, hirudoterapia o terapias derivadas de sanguijuela. Si bien la terapia con sanguijuelas se emplea en ocasiones como adyuvante en la reimplantación digital para la congestión venosa, este estudio no aborda esa aplicación, y no existe una relevancia defendible relacionada con las sanguijuelas basándose solo en el resumen.
Citación
Digital avulsion injuries: epidemiology and factors influencing finger preservation.
Struckmann VF et al. · Archives of orthopaedic and trauma surgery, 2020
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026