Back to Search
Start Over
Multilevel Dysvascular Injury of the Hand: Replantation versus Revision Amputation
- Source :
- Plastic & Reconstructive Surgery. 146:819-829
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Background Multilevel dysvascular injury of the hand can be treated with replantation or revision amputation. The authors compared both modalities regarding functional outcomes, patient-reported outcomes, and required resources, as relevant studies are scarce. Methods In this retrospective review of consecutive case series (replantation, n = 8; revision amputation, n = 11), clinical results and functional outcomes (including grip strength, range of motion, sensory recovery, and grip or pinch ability) were assessed. Patient-reported outcomes, required hospital resources, and treatment cost until 1 year after surgery were compared between both groups. Results Six patients used passive prostheses, two used body-powered prostheses, and three did not use a prosthesis in the revision amputation group. All patients in the replantation group could grip objects and had restored hands, with protective sensory recovery and substantial wrist motion, whereas six patients in the revision amputation group were unable to grip or pinch objects. Replantation was associated with superior patient-reported outcomes, but required more hospital resources and treatment costs. Conclusions This study suggests that in the treatment of multilevel dysvascular injury of the hand, the surgical method should be chosen on a case-by-case basis. For better functional and patient-reported outcomes, replantation is preferred. Revision amputation can be performed in the absence of sufficient hospital resources and to reduce treatment cost. These findings can aid in the preoperative counseling of patients with multilevel dysvascular injury of the hand. Clinical question/level of evidence Therapeutic, III.
- Subjects :
- Adult
Male
Reoperation
medicine.medical_specialty
medicine.medical_treatment
030230 surgery
Wrist
Prosthesis
Amputation, Surgical
Young Adult
03 medical and health sciences
Grip strength
0302 clinical medicine
medicine
Humans
Aged
Retrospective Studies
business.industry
Hand Injuries
Retrospective cohort study
Hand surgery
Recovery of Function
Consecutive case series
Middle Aged
Hand
Treatment Outcome
medicine.anatomical_structure
Replantation
030220 oncology & carcinogenesis
Physical therapy
Female
Surgery
business
Range of motion
Subjects
Details
- ISSN :
- 00321052
- Volume :
- 146
- Database :
- OpenAIRE
- Journal :
- Plastic & Reconstructive Surgery
- Accession number :
- edsair.doi.dedup.....fd7ea1952743fc139b9c1058dd6a020c