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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Late outcomes after hand replantation

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  • presenting/speaker Andrzej Zyluk - Pomeranian Medical University, Szczecin, Poland
  • Ada Owczarska - Pomeranian Medical University, Szczecin, Poland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-441

doi: 10.3205/19ifssh0973, urn:nbn:de:0183-19ifssh09735

Published: February 6, 2020

© 2020 Zyluk et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: The objective of this study was evaluation of functional outcomes in patients whose underwent successful replantation of amputated hands in author's institution at least 4 years before.

Methods: 54 patients who underwent successful replantation of amputated hands or fingers were identified. These patients were mailed a set of questionnaires asking for hand function (DASH questionnaire), quality of life (SF-36), cold intolerance and return to work. 22 completed questionnaires returned (response rate 41%) and these data was a subject of the analysis. This group comprises also 5 patients who were examined directly in the hospital. The group consisted of 22 patients, 20 men and 2 women, in a mean age of 43 years (range 20-82), who had performed hand or fingers replantation a mean of 6,5 years before the assessment (range 5-7). The most patients had amputation of the metacarpus (n=9), followed by fingers II-V (n=8), wrist (n=2), thumb (n=2) and forearm (n=1). The cause of amputation was circular saw in 15 cases (68%) followed by industrial or agriculture machinery.

Results and Conclusions: A mean DASH score for a whole group was 23 (range 2-74) what shown for an average mild dysfunction of the replanted hands. Ten patients (45%) regained very good function (DASH< 20), seven (32%) showed mild dysfunction (DASH 21-40) and five had greater disability (DASH >40). The patients following wrist and thumb replantation showed the best functional outcomes (DASH 4), less favorable had patients after finger II-V replantation (DASH 16) and the poorest showed patients after metacarpus and forearm replantation (DASH 33). The mean score in physical subscale of the SF-36 questionnaire was 61, indicating good quality of life. For mental SF-36 subscale the mean score was 58 indicating moderate quality of life. Twenty patients complained of troublesome symptoms of cold intolerance. Twelve patients (54%) returned to previously performed work.

Results of this study show that most patients regained good function of replanted hands allowing them good functioning in a daily life and return to work in proportion of them.