The pocket method gives poor results when used for fingertip amputations with bony fragments

Abstract

Background: The aim of this study is to investigate the mid-term results of subdermal pocket replantation without vessel repair on fingertip amputation cases with bone fragments. Methods: In 2018-2019, nine patients’ eleven fingers whose fingertip amputation could not be repaired and be aplied sub- dermal pocketing were included in the study. Satisfaction level, range of motion, length and survival rate, two-point static discrimination and Semmes Weinstein monofilament test were applied. Results: All of the patients included in the study were male and the mean age was 35.2 ± 13.5 years. The mean time be- tween insertion and removal of the finger in the pocket is 16.45 ± 2.42 (14-21) days. The median of SMWT was 2.83 (2.83 – 6.65) and the mean of S2PD was 3.62 ± 0.38 (2.00 – 6.00) mm. The mean score of satisfaction was 65.9 ± 27.9 (0 – 100) out of hundred. Three patients’ three fingers survived and this patients were named as group A, and the other 6 patients (8 fingers) were named as group B. The average survival rate of three patients was 71.7 ± 33.2%. There was no statistically significant difference between groups in terms of age, waiting time in the pocket, SWMT, S2PD and satisfaction scores. Conclusions: Although pocket replantation method is an easy method to apply, it does not show perfect results in cases with bone fragments. It seems to be a viable method for providing venous drainage in fingertip amputations where artery repair can be performed but vein repair cannot be performe