Long-Term Subjective and Functional Evaluation After Thumb Replantation With Special Attention to the Quick DASH Questionnaire and a Specially Designed Trauma Score Called Modified Mayo Score

Abstract

Several authors have reported overall survival rates after thumb replantation; however, to date, only few studies have been concerned with functional outcome after thumb replantation, with assessment of range of motion, grip strength, and additional functional tests (Quick DASH and modified Mayo score). We chose to design and execute a study to evaluate the functional and subjective results after thumb replantation. A total of 34 patients (3 women and 31 men) with replanted thumbs returned for additional testing that consisted of an interview using the Quick DASH questionnaire and physical examinations including objective measurements of hand strength, range of motion, and sensibility. These objective measurements as well as satisfaction and pain were evaluated with the specially designed trauma score called modified Mayo score. Furthermore, correlation analyses between Quick DASH, modified Mayo score, and objective parameters were performed. The Quick DASH score was 11.3 (SD, ±10.79). The modified Mayo score was 110 points (SD, ±15.11). Finally, the Quick DASH score showed a significant correlation with our modified Mayo score (Kendall tau rank correlation coefficient, τ = -0.25; p = 0.04). Functional results were independent of amputation level, length of ischemia, and patients age. Although sensory recovery and functional outcomes of the extrinsic muscle system were moderate, patients were able to use their thumb to perform work and daily living activities. The significant correlations of objective clinical tests and a mixed trauma score (modified Mayo score) with the Quick DASH allows the clinician to compare the postoperative result with the patient' functional competence in daily activities.