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Long‐term functional and subjective results of thumb replantation
Author(s) -
Unglaub Frank,
Demir Erhan,
Von Reim Roland,
Van Schoonhoven Jorg,
Hahn Peter
Publication year - 2006
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.20287
Subject(s) - replantation , medicine , thumb , amputation , grip strength , range of motion , dash , hand strength , microsurgery , metacarpophalangeal joint , avulsion , surgery , upper limb , physical therapy , physical medicine and rehabilitation , computer science , operating system
Abstract The aim of this follow‐up study was to evaluate the functional and subjective results after thumb replantation. Twenty‐four patients with replantation of the thumb, performed during the period 1992–1997, were reexamined after 6.5 years (range, 4.2–9.1 years post‐injury). In 10 cases the amputations were isolated, 14 amputations were combined with other injuries of the hand, 15 amputations resulted from crush/avulsion injuries, and 9 amputations were sharp. Range of motion, grip strength, cutaneous sensibility, and upper‐extremity functioning using the DASH questionnaire were determined. A correlation analysis with important variables was performed. Average range‐of‐motion in the metacarpophalangeal joint was 44° (±24.2) and in the interphalangeal joint was 12° (±8.4). Grip‐strength of the injured hand was 70% (±31.4) and pinch strength was 68% (±28.7) in comparison to the non‐injured hand. DASH‐scores correlated with grip‐strength, pinch‐strength, and cutaneous sensation but no correlation was found between DASH and the level of amputation. Functional results were independent of amputation levels and patient age. Although the results of cutaneous sensibility were only moderate, patients were able to use their thumb to perform work and daily living activities. The majority of patients had returned to their previous occupation. © 2006 Wiley‐Liss, Inc. Microsurgery, 2006.