Clinical Results of Minor Upper Extremity Replantation and Revascularisation Patients in Comparison to the Literature: A Clinical Study

Abstract

Objectives: To evaluate the minor upper extremity replantation and revascularisation cases and to compare the clinical results with those in the literature. Materials and Methods: Our study covers upper extremity trauma repair operations of 35 fingers of 30 patients who recieved treatment in our clinic betwen 2008 and 2011 date. The total number of amputated fingers that underwent replantation was 15 (of 15 patients) while 20 fingers of 15 patients underwent revascularisation operation for amputated fingers. We have conducted a retrospective study of the early period results of patients, who have been followed for an average of 17 months (6 months - 3.5 years). Results: The survival rate for replantation cases was 93.3%; this rate was 80% for revascularised fingers. The survival rate for zone 2 injuries was 66.6%; the survival rate for zone 3 injuries was 92.3%. The survival rate for guillotine type injuries was 100% of the; this rate was 68.8% for crush and avulsion type injuries. The evaluation of functional results based on Chen criterion and in terms of injury patterns has shown that 89.9% of guillotine-type incision patients showed very good results while 33.3% of the crush and avulsion type injury patients returned with very good results as 44.4% of these patients showed moderate results. The statistical evaluation of the functional outcomes of the distal parts showed better improvemnet in guillotine-type injuries compared to crush and avulsion type injuries. Conclusions: Minor replantation and revascularisation operations are difficult and require various equipments. Our results are compatible with the literature in terms of the large replantation series. Keywords: Replantation; Revascularization; Total-Subtotal Amputation.