title: The outcomes of digital tip amputation replacement as a composite graft in a paediatric population.
abstract: Limited studies exist on the outcome of replacing an amputated fingertip as a composite graft. We report the outcomes and predictors for composite graft survival along with the long-term morbidity. A retrospective review of all patients <16 years who underwent composite graft replacement of an amputated fingertip was performed. Long-term morbidity was evaluated through a standardized parental questionnaire. A total of 120 patients were identified, of whom 97 were eligible for inclusion. Parental questionnaires were completed for 42 (43%) patients. There was a 10% complete and 34% partial graft survival rate. Patients aged ⩽4 were significantly more likely to have complete graft take than those >4. Of the patients, 17% developed post-operative complications; 48% of patients reported a hook-nail deformity and 17% reported cold intolerance. Only 5% of patients reported any functional difficulties long term. The rate of complete composite graft survival in a paediatric population is low, although the long-term function of these patients is good.
  
  
  METHODS
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authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK danielbutler@nhs.net.
authors.forename: D P
authors.initials: DP
authors.lastname: Butler
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Murugesan
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Ruston
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Woollard
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Jemec
mesh_terms: D000293:Adolescent; D000673:Amputation, Traumatic; D002648:Child; D002675:Child, Preschool; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D008297:Male; D012092:Replantation / Q000379:methods*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Amputation; composite graft; fingertip