Article
Late outcomes after hand replantation
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Published: | February 6, 2020 |
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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.