Long-term Functional, Subjective, and Psychological Results After Digit Replantation

Abstract

Objective: Some inconsistencies can be observed among subjective satisfaction, objective functional results, and psychological sequelae. The aim of this follow-up study was to present the long-term comprehensive results of successful digit replantation and to analyze the relevance among subjective satisfaction, objective functional results, and psychological sequelae. Materials and Methods: In 26 patients with successful digit replantation, 28 cases were reexamined after 36.9 months (range, 25–49 months postinjury). The range of active motion of joints, grip and pinch strength, cutaneous sensibility, upper-extremity functioning, and subjective satisfaction using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Michigan Hand Outcomes Questionnaire (MHQ), and psychological sequelae including depression, anxiety, and postraumatic stress disorder (PTSD) were assessed. A correlation analysis among variables was also performed. Results: According to the Strickland criteria, the active motion of digits was excellent in 4 (15%), good in 6 (5%), fair in 9 (35%), and poor in 9 (45%) digits. The mean value of the total grip, pinch strength, and the Semmes-Weinstein monofilament testing exceeded 80% of value of the healthy hand. However, the average value of static two point discrimination (s2PD) was less than half value of the healthy hand. The mean score for the DASH and MHQ was 6.9 and 58.9, respectively. The incidence of cold intolerance was 60%. Only 1 patient has showed the symptoms of depression and PTSD after 49 months postinjury as yet. Almost all patients returned to work and half of them did not change their former type of occupations. Conclusions: We concluded that the objective functional results of replanted digits did not affect the daily life and satisfaction of patients.