Fingertip injuryA Retrospective Study of Functional Outcomes After Successful Replantation Versus Amputation Closure for Single Fingertip Amputations
Section snippets
Inclusion and exclusion criteria
The primary inclusion criterion of this study was a single fingertip amputation treated by either successful microsurgical replantation or amputation closure as a primary procedure. We classified the level of amputation according to Tamai (ie, zone 1 for amputations distal to the nail base and zone 2 for amputations between the distal interphalangeal joint and the nail base).4 Patients with zone 1 amputations were included in this study. The minimum postoperative follow-up period was 24 months
Results
The age at the time of injury and the distribution of the affected fingers did not differ significantly between the 2 groups. The follow-up period for patients in the successful replantation group was statistically longer.
The grip strength did not differ significantly between the 2 groups. Active ROM of flexion of the PIP joint in the successful replantation group was significantly greater. No patients in either group changed their occupation after the injury. Although the existence of
Discussion
The primary goal for treatment of fingertip amputation includes maintenance of digital length, good soft-tissue coverage, painless fingertip with durable and sensate skin, and preservation of the nail. From these points of view successful replantation seems an ideal method for treatment of fingertip amputation. The long-term results of our 23 successful replantations were encouraging. The average active ROM of the distal interphalangeal joint in 18 fingers, when preserved, was −2° ± 6° of
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