Factors associated with secondary ray amputation after initial finger amputation at the traumatic level

Abstract

Background: To assess if surgeon specialty, demographics, or injury-related variables are related to a second operation to convert a finger amputation at the level of injury to a ray amputation. Methods: We identified 869 patients that had a finger (non-thumb) amputation at the level of injury over the period between 2000 and 2015. Bivariable analyses were used to identify factors associated with a second operation for ray amputation. Results: Eighteen patients had secondary ray amputation (2.1%), 8 for stiffness and contracture, 5 for pain, and 5 for necrosis of the stump. Factors associated with secondary ray amputation include central finger, amputation at a more proximal part of the finger, and other injured fingers that were not amputated. Conclusion: A second operation for ray resection is uncommon after major trauma, more likely proximal and central, usually done for pain or dysfunction, and performed equally in patients treated by plastic or orthopedic hand surgeons.