Functional Outcome Following Hand and Wrist Level Replantation: A Retrospective Review

Rahul K Patil ,Gopal Malhotra,Venkata Nageshwara Reddy Komma,Abdullah Al Harthi,Emad M Ibrahim

doi:10.31487/j.scr.2020.12.25

Abstract

Objective: Amputations of fingers and significant parts of upper limbs are common following industrial injuries. This study was aimed at assessing the functional outcome in patients with hand replantation following amputation at the level of distal forearm or wrist. Methods: Patients presenting with amputation at the level of wrist and forearm between Jan 2015 and December 1018, with adequate follow up were included. The function in terms of total active motion at the fingers and wrist, sensory recovery, and patient satisfaction and DASH scores at the final follow up were noted. Results: Four cases of replantation at the level of wrist and one replantation at distal forearm level were included in the study. A total of 3 patients were excluded for various reasons. The average follow-up period was 38 months. The average total active motion of fingers achieved was 212○ . All patients recovered protective sensations. Conclusion: Replantation of amputated major upper limb parts restores useful function and should be attempted. Minimizing ischaemia time, secure fixation, primary repair of structures and early motion are determinants of reasonable functional outcome. Level of evidence: IV.

Highlights

Amputation of a significant part of the limb is a devastating injury that is likely to have long-lasting functional and psychological consequences on the patient's life
Charts of the included patients were reviewed for the age, gender, extremity involved, the mechanism of injury, the ischaemia time, the procedure performed, outcome, complications if any and secondary surgeries performed
The functional outcome and not mere survival has become the primary determinant of success in replantation surgery [6, 7]

Summary

Introduction

Amputation of a significant part of the limb is a devastating injury that is likely to have long-lasting functional and psychological consequences on the patient's life. A systematic review has suggested high satisfaction rates as well as the psychological superiority of replantation over the prosthesis [7,8,9]. In this retrospective study, we have tried to assess the functional outcome following replantation at the level of wrist and the forearm. We have tried to assess the functional outcome following replantation at the level of wrist and the forearm This is first such report assessing function after replantation from Sultanate of Oman

Methods

Results

Conclusion