The Journal of Bone and Joint Surgery, Vol 67, Issue 4 611-619, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
The results of replantation after amputation of a single finger
JR Urbaniak, JH Roth, JA Nunley, RD Goldner and LA Koman
We reviewed fifty-nine consecutive cases of patients who had replantation
of a single finger (excluding the thumb) after traumatic amputation, with
an average follow-up of fifty-three months. Fifty-one (86 per cent) of the
replanted fingers survived. Survival was found to be affected by the age of
the patient, the number of vessels that were anastomosed, and the
replantation experience of the surgeons. The survival rate was not affected
by the gender of the patient, the mechanism of injury, or which finger was
amputated. As compared with survival only, the functional results were most
dependent on the level of amputation. The proximal interphalangeal joint in
amputated fingers that were replanted distal to the insertion of the flexor
superficialis tendon had an average range of motion of 82 degrees after
replantation, while those amputated proximal to the insertion had an
average range of motion of only 35 degrees after replantation. The average
operating time was six hours and ten minutes, and the average time until
the patient returned to work was 2.3 months. Based on this experience, it
is our opinion that replantation of a single finger that was amputated
distal to the insertion of the flexor superficialis tendon is justified,
but that replantation of a single finger that was amputated proximal to
this insertion is seldom indicated.
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