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Traumatic amputations of the thumb. Indication for replantation, technique and long-term results



Traumatic amputations of the thumb. Indication for replantation, technique and long-term results



Chirurg 66(11): 1110-1114



Between 1981 and 1990 thumb replantation was performed in 160 patients. The standard procedure is presented. Among 122 isolated thumb amputations 97 could be replanted successfully (79.5%). In 38 patients having suffered additional amputations of other fingers the thumb could be preserved in 29 cases (76.3%). The over-all survival rate was 78.8%. Division of the reported period into two five-year terms revealed survival rates in single-digit amputations of 80.7% (1981-1985) and 79.1% (1986-1990), and 74.1 resp. 81% in multiple-digit amputations. Success of the procedure was dependent on the severity of the injury, duration of ischemia and experience of the surgeon. 89 patients were reexamined with a mean follow-up of 2.3 years. After single-digit replantation the functional outcome was 70.3% compared with the contralateral hand according to Millesi's system. This value was 40.5% after multiple-digit replantation. The evaluation of the outcome after single-digit replantation according to Tamai revealed in 56.7% very good, in 26.7% good and in 16.7% fair results. Results were very good in 9.8%, good in 52.2%, fair in 24.6% and unsatisfactory in 13.1% among patients after multiple-digit replantations.

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