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Introduction: Thumb replantation following complete amputation is a relatively frequent and well-established surgical procedure. In literature many studies report a discrepancy between the objective measurements and the subjective satisfaction of the patients. Nowadays, evaluation of the patient long-term benefit obtained by replantation is uncertain. The aim of this study was to consider the long-term results of 33 thumb replantation procedures., Methods: The period considered is from January 1997 to December 2015, 33 subjects fulfilled the study inclusion criteria and were included in the study. We evaluated in each patient: ROM (performing Kapandji test), level and mechanism of amputation, force peak of three grips using Dexter dynamometer (five-handle, key, tri-digital grips), sensibility (using Disk-Criminator and aesthesiometers of Semmes-Weinstein) and subjective perception of disability (using DASH questionnaire)., Results: All patients were males, 94% of them returned to their previous occupation. Average follow-up was 9±4 years. The prevalent mechanism of injury was a combined amputation in 58% of cases. Levels involved in more than half of patients were interphalangeal joints and proximal phalanxes. Ratios of strength recovery were: for the five-handle grip equal to 0.90±0.28 kg (p=0.63), 0.78±0.30 kg (p=0.64) for key grip and 0.75±0.32 kg (p=0.78) for tri-digital grip. Results for Kapandji test was 8±2 and for DASH test was 16±21. The protective tactile threshold was recovered in 49% of patients; S2PD test resulted positive in 54% and D2PD test in 39% of cases., Conclusions: Results confirm and strengthen evidence of positive long-term functional outcomes of thumb replantation interventions., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020. Published by Elsevier Ltd.)

Techniques to improve the chance of successful replantation of digits are well established. Indications and contraindications for replantation are generally agreed on, but they continue to evolve as excellent outcomes are achieved at centers with experience and expertise. Form and function can be restored with avulsion injuries and distal amputations, with good results and high patient satisfaction. Increased financial pressure to control the costs of health care and increased accountability for evidence-based outcomes may lead to the regionalization of replantation care and shared decision making in recommending replantation or revision amputation., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The aim of this retrospective study was to analyse the results of 20 thumb replantations with special and exhaustive attention on functional outcomes. Twenty patients with traumatic thumb amputation were enrolled in the study. Range of motion, grip strength, sensory recovery, and subjective perception of overall hand function recovery were measured. The average age at the time of surgery was 35 years (range, 13-73 years). The mean follow-up was 3.25 years (range, 1.9-10.25 years). The long-term results of thumb replantation confirmed satisfactory outcomes in terms of general upper limb function, handgrip and pinch strength, and social and work reintegration. Sensory recovery remained unsatisfactory despite the fact that we did not need to perform any kind of revision surgery as a consequence of inadequate thumb sensibility. For the first time in the existing literature, no functional parameter that contributes to the assessment of the function of replanted thumbs has been excluded. We resume in the same study the analysis of all functional parameters that are useful to define results of thumb replantation., (Copyright © 2012 Elsevier Ltd. All rights reserved.)