A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers

Abstract

Objectives: This study aims to evaluate the clinical results andexperiences in a community hospital regarding procedures for thereplantation and revascularization of fingers.Patients and methods: Between June 2015 and December 2019,a total of 58 patients (51 males, 7 females; mean age: 33.4±6.3years; range, 23 to 46 years) who were followed after totaland/or subtotal amputation and replantation were retrospectivelyanalyzed. The patients were evaluated at nine months in terms ofcold intolerance, static two-point discrimination, and functionalresults using the range of motion (ROM) and Quick Disabilities ofthe Arm, Shoulder and Hand (QuickDASH) questionnaire.Results: The majority of the patients presented withwork-related injuries (70%), most commonly by the mechanismof guillotine (64%), and to the dominant hand (76%) and thethird finger (36%) most frequently. The overall successrate of digit salvage was 72.9% (n=51). Of 19 digits withunsuccessful surgical outcomes, seven were from total and12 were from subtotal amputations. In the long-term, coldintolerance was observed in 14 patients (24.1%) accordingto the cold intolerance severity scale. The mean static twopoint discrimination value was 6.0±0.7 mm and the meanQuickDASH score was 22.3±5.0. The mean ROM measuredat nine months after surgery in the metacarpophalangealand interphalangeal joints of the third and fourth digits wassignificantly lower than that in the others (p