Results of secondary single ray resection without transposition of an adjacent digit

Abstract

In this study, we retrospectively reviewed and analysed results of secondary single ray resection in ten patients (eight males and two females) whose average age was 40.5 years (range, 27–64 years). The mean time for surgery after initial injury was 34.5 months (range, 1–300 months). There were seven manual workers, two intellectual workers, and one student. Cases were reviewed 3–12 years after surgery (median, 6 years). Nine patients were right-handed and one was left-handed. The injuries involved five dominant hands (50%) and five nondominant hands. Lesions touched preferably border digits in eight cases (seven index and one fifth), and central digits in two cases (one long and one ring). Patients had an average total time off from work of 5.1 months (range, 3–8 months), and an average time of 2.4 months (1–4 months) if considered only the post-operative period after ray resection. The patients were all re-evaluated questionnaires, physical examination, and functional testing. Seven of the ten patients (70%) returned to their pre-injury activity. On the whole, seven results have been considered as excellent; two as good and one as medium. However, despite these good results and in order to decrease the long time period lost off work, to avoid disability and high social cost, we believe that primary ray resection could be proposed to patients in some elective cases as an alternative choice for a better result, taking into consideration certain decisional factors particularly age, sex, occupation, dominant hand, severity of injuries, as well as the advantages and inconveniences of primary or secondary ray resection.