[Sensory recovery after finger replantation].
Criteria for digital replantation is not only revascularization the prerequisite for success, but above all functional recovery of sensibility. In cases of digital replantation, it is necessary to pay special attention to the technical details of nerve repair, for recovery of tactile gnosis. 202 patients with 247 digital amputations were successfully replanted. 138 patients with 172 successfully replanted fingers and 302 digital nerve reconstructions returned for follow-up evaluations. Our aim was to determine the level of sensory recovery depending on the Highet (1954) sensory recovery scheme. Nerve reconstruction was divided into three groups: primary nerve repair, primary nerve grafting, and secondary nerve grafting. 69.4% primary nerve coaptations, 58.3% primary nerve grafting, and 61.9% secondary nerve grafting reached S3 to S4. Most of the replanted fingers regained useful 2PD with S3+. Factors that influenced digital sensibility following replantation including level and mechanism of injury, length of the nerve grafts, cold intolerance, and patient's age are finally discussed in detail.
Orthopädischen Klinik und Poliklinik, Freien Universität Berlin im Oskar-Helene-Heim.
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000294:innervation*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology*; D009460:Neurologic Examination; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology; D012092:Replantation / Q000379:methods*; D012678:Sensation Disorders / Q000503:physiopathology*; D013536:Suture Techniques