Replantation and amputation of digits: user analysis.
There now is extensive literature on the survival and function of replanted digits but little on the function of the hand as a whole after this procedure, as opposed to amputations. In our review of the literature, we found almost nothing on the patient's perspective of the outcome from these procedures. This study was a preliminary attempt to study the outcome of these procedures from the patient's viewpoint. There were nine replantations and ten amputations of digits in the final study groups, based on medical record screening and patient questionnaires. Multivariate analysis, Hotelling T2, was used to test significant differences between the variables in the two groups. Significant differences were found in the two groups. The replantations had longer lengths of treatment and therapy, were off work longer (34.4 wk of therapy and 40 wk off work), and rated their function poorer compared with amputations. The patients with digit amputations had 7.2 wk of therapy and lost 6.8 wk of work. Ninety percent of the amputees rated their function as good or excellent, in contrast to 44.4% of the replantation patients. These findings are supported by existing literature that suggests that single-digit replants do not help with function of the whole hand, which is the therapeutic aim.
Goel
A
A
Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City 66160-7306, USA.
Navato-Dehning
C
C
Varghese
G
G
Hassanein
K
K
D000041:Absenteeism; D000203:Activities of Daily Living; D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D012092:Replantation / Q000534:rehabilitation; D012189:Retrospective Studies; D013997:Time Factors