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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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Is a replanted digit used in activities of daily living? A study on non-use rate of replanted digits

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  • presenting/speaker Yukihiro Osanami - Sapporo Medical Rehabilitation College, Sapporo, Japan
  • Ayumu Echigo - Division of Orthopaedic Trauma, Sapporo Tokushukai Hospital, Sapporo, Japan
  • Koji Ibe - Division of Orthopaedic Trauma, Sapporo Tokushukai Hospital, Sapporo, Japan
  • Yoshiaki Kurata - Division of Orthopaedic Trauma, Sapporo Tokushukai Hospital, Sapporo, Japan
  • Hideki Tsuji - Division of Orthopaedic Trauma, Sapporo Tokushukai Hospital, Sapporo, Japan

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. DocIFSHT19-1077

doi: 10.3205/19ifssh1492, urn:nbn:de:0183-19ifssh14922

Published: February 6, 2020

© 2020 Osanami 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

Text

Objective: After digital replantation, patients frequently stop using the replanted digit in their activities of daily living (ADL). The purpose of this study was to investigate the non-use rate of replanted digits in ADL.

Materials and Methods: This study included 30 fingers in 28 patients treated for finger amputation injuries from 2014 to 2016. We included patients with amputations in Tamai's zone 1 to 4 of the thumb (5 fingers), index finger (14 fingers), or middle finger (11 fingers) who underwent digital replantation surgery and were followed for minimum of 5 months.

Patients consisted of 26 males and 2 females, with an average age of 43 years (17-74). The use of the replanted digit was evaluated using the modified ADL scale developed by Saito et al. (2008 in Japan) and the performance of finger movement without the use of the replanted digit was reported as the "finger non-use rate". We also investigated the reasons for not using the replanted digit. The functional evaluation was done using the Semmes-Weinstein monofilament test (SWT), the static 2-point discrimination, evaluation of the numbness by VAS, % total active motion, grip strength, and the Disabilities of the Arm, Shoulder, and Hand score. Correlation between the finger non-use rate and each functional evaluation was calculated using Spearman's correlation coefficient (significance level 5%).

Results: The average finger non-use rate was 41% (thumb 42%, index finger 53%, and middle finger 26%). The reason for not using the replanted finger was sensory disorder (40%), fear (25%) and difficulty of use (25%). There was a negative correlation between the finger non-use rate and SWT (r = - 0.55, p = 0.002). There were no significant differences among the other evaluations.

Conclusions: This study suggested that poor SWT results lead to a lower rate of replanted digit use in ADL. Adequate evaluation of the replanted digit status and its functionality together with appropriate sensory re-education are important for therapy after digital replantation.