title: To trim or replant: a matter of cost.
abstract: Many factors are involved in the decision whether to complete the amputation of an injured digit and trim the stump or to replant the amputated member. This paper compares the cost of these two treatments so that this financial aspect might be included among the many factors which influence the surgeon's decision. The cost of these treatments was separated into two aspects. First, the overall cost of the medical and surgical expenses was calculated. Second, the cost which the Israeli social security granted the injured worker due to the disability was calculated. By comparing the total surgical and medical costs of amputations and replantations, trimming is far less expensive than replantation. In the long run, the compensation the insurer owes the disabled trimmed patient is far higher than the compensation given to those who were successfully replanted, provided the injured worker has a certain number of working years to retirement and has a yearly income of a certain level. Thus, in most cases, replantation is recommended from the cost benefit aspect.
authors.affiliation: Department of Hand Surgery, Sheba Medical Center, Sackler School of Medicine, Tel Hashomer, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Engel
authors.forename: S
authors.initials: S
authors.lastname: Luboshitz
authors.forename: B
authors.initials: B
authors.lastname: Jaffe
authors.forename: Z
authors.initials: Z
authors.lastname: Rotstein
mesh_terms: D000673:Amputation, Traumatic / Q000191:economics* / Q000601:surgery; D003365:Costs and Cost Analysis; D005260:Female; D005383:Finger Injuries / Q000191:economics* / Q000601:surgery; D006801:Humans; D008297:Male; D008722:Methods; D012092:Replantation / Q000191:economics*; D014481:United States