title: A systematic review of outcomes of revision amputation treatment for fingertip amputations.
abstract: OBJECTIVE
  The purpose of this study was to conduct a systematic review of outcomes of fingertip revision amputation for fingertip amputation injuries in the English-language literature to provide best evidence of functional outcomes.
  
  
  METHODS
  A MEDLINE literature search was performed to identify studies that met the following criteria: (1) reported primary data; (2) included at least five cases of primary revision amputation treatment following digit amputation injury; (3) reported finger or thumb amputation at or distal to the distal interphalangeal (DIP) joint or interphalangeal (IP) joint, respectively; (4) presented at least one of the following outcomes: static two-point discrimination (2PD), cold intolerance, arc of motion (AOM) of metacarpophalangeal (MCP) joints, proximal interphalangeal joints (PIP), DIP joints, or return-to-work time.
  
  
  RESULTS
  Thirty-eight studies met the inclusion criteria. Twenty-seven studies reported 2PD, 20 studies reported cold intolerance, eight studies reported AOM, and 18 studies reported return-to-work time after revision amputation of fingertip injuries. The mean 2PD was 5.6 mm. On average, 24 % of patients experienced cold intolerance. AOM at the PIP joint was reported in four studies and averaged 94°. DIP joint AOM was presented in four studies and averaged 66°. Thumb MCP and IP joint AOM was presented in three and four studies, respectively. Mean thumb MCP joint AOM was 54° and that of the IP joint was 71°. The mean return-to-work time was 47 days.
  
  
  CONCLUSIONS
  On average, fingertip revision amputation can achieve almost normal sensibility and satisfactory motion and patients can expect to return to work on average approximately 7 weeks after surgery.
authors.affiliation: 17th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Keming
authors.initials: K
authors.lastname: Wang
authors.affiliation: Section of Plastic Surgery, The University of Michigan Health System, Ann Arbor, MI USA.
authors.forename: Erika Davis
authors.initials: ED
authors.lastname: Sears
authors.affiliation: Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, MI USA.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Shauver
authors.affiliation: Section of Plastic Surgery, University of Michigan Medical School, 2130 Taubman Center, SPC 5340, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5340 USA ; Faculty Affairs, The University of Michigan Medical School, 2130 Taubman Center, SPC 5340, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5340 USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Chung
keywords: Fingertip amputation; Hand surgery outcomes; Systematic review; Treatment