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161914

FINGER REPLANTATION: GOOD AND BAD RESULTS

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Last updated: 05 Jan 2025

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Abstract

There are different causes for finger amputation. Causes are starting from clean cut amputation up to avulsion. There are many factors affecting the results of finger replantation, as cause of injury, age of the patient, level of amputation, time passed after injury, methods for preservation of the amputated part, trained surgeons, and surgical equipments. Other factors affect the results of finger replantation are number of digital amputation, surgeon comfortability, and patient cooperation. This study included 38 patients presented by amputation of 57 fingers. The average age was 23 years old. The main cause was machine injury. The dominant hand was the right hand. The dominant finger was the thumb. The level of injury was proximal to the proximal interphalangeal joint in most of cases. The average time passed between injury and replantation was 2 hours. The average time of surgery for one digit replantation was 4 hours. The principles of treatment was exploration of the neurovascular and tendons in the amputated digit initially then that of the stump. The order of treatment was bone fixation by 2 kirschner wire, digital artery, digital vein, flexor tendon, digital nerve, extensor tendon. Skin closure should be loose. The average follow up was 58 months. All fingers have been survived except five. The average time for bone union was 8 weeks. According to Chen's criteria, the overall results were classified as grade I (excellent) in 20 cases, grade II (good) in 16 cases and grade III (fair) in 2 cases. The tendon function was excellent in 20 fingers, good in 26 fingers fair in 3 fingers, poor in 2 fingers and failure in 6 fingers. The 2 point discrimination was 6 mm in 9 fingers, 7-10 mm in 29 fingers, and 12-15 mm in 13 fingers. The mean grip and pinch strengths were 80 % and 85% respectively compared to contralateral hand. All of patient had returned to their normal daily activities. Finally, finger replantation is not an easy job and it is considered as challenging procedure even for the specialist. I think that many factors affecting the results of finger replantation have not been discovered yet.

DOI

10.21608/ejor.2020.161914

Keywords

Digital amputation, Microvascular anastomosis, Replantation, Discrimination

Authors

First Name

Wael

Last Name

Salama

MiddleName

-

Affiliation

Orthopedic Surgery dept., Faculty of Medicine, Sohag Univ., Sohag, Egypt

Email

waeladel582@gmail.com

City

-

Orcid

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First Name

Yasser

Last Name

Soror

MiddleName

-

Affiliation

Orthopedic Surgery dept., Faculty of Medicine, Sohag Univ., Sohag, Egypt

Email

-

City

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Orcid

-

First Name

Mohamed

Last Name

Ali

MiddleName

-

Affiliation

Orthopedic Surgery dept., Faculty of Medicine, Sohag Univ., Sohag, Egypt

Email

mohamedaliortho82@gmail.com

City

-

Orcid

-

First Name

Panayotis

Last Name

Soucacos

MiddleName

-

Affiliation

Orthopedic research & Education Center “Attikon" University Hospital, Athens, Greece

Email

psoukakos@ath.forthnet.gr

City

-

Orcid

-

First Name

Hassan

Last Name

Noaman(*)

MiddleName

-

Affiliation

Orthopedic Surgery dept., Faculty of Medicine, Sohag Univ., Sohag, Egypt

Email

-

City

-

Orcid

-

Volume

1

Article Issue

1

Related Issue

23715

Issue Date

2020-05-01

Receive Date

2021-04-07

Publish Date

2020-05-01

Page Start

17

Page End

26

Print ISSN

2682-4744

Online ISSN

2314-6710

Article File

EJOR_Volume 1_Issue 1_Pages 17-26.pdf

PDF . 707.7kB

Link

https://ejor.journals.ekb.eg/article_161914.html

Detail API

https://ejor.journals.ekb.eg/service?article_code=161914

Order

3

Type

Original articles: include clinical trials, interventional research, Basic researches and clinically relevant laboratory investigations

Type Code

1,828

Publication Type

Journal

Publication Title

Egyptian Journal of Orthopedic Research

Publication Link

https://ejor.journals.ekb.eg/

MainTitle

FINGER REPLANTATION: GOOD AND BAD RESULTS

Details

Type

Article

Created At

23 Jan 2023