A new technique for metacarpophalangeal joint replantation after four-finger amputation

Abstract

Although finger amputations are not life-threatening, they are functionally and psychologically problematic for the patient. Successful replantation of amputated fingers results in better appearance and functional outcome. Therefore, the patient's satisfaction and psychological status improve. Usually, the first step of replantation involves bone and joint fixation. Various fixation methods can be used. Rapid and rigid fixation allows the surgeon to focus on repairing the soft tissues. In this report, we describe four-finger metacarpophalangeal (MCP) joint replantation with a new technique where no fixation device is used for the MCP joints. All four fingers survived and the total active motion of the four fingers ranged from 220 to 250 degree. Grip strength was 40kg and pinch strength was 5kg. Two-point discrimination was ranged from 4 to 8mm. We achieved a successful outcome comparable to previous reports. In conclusion, when amputation occurs at the MCP joint level, the fixation stage can be omitted to allow early repair of soft tissues.