A prospective randomised comparison of fixation methods in Tamai's zone I amputation

Shim, Hyung-Sup; Kwon, Byung Yeun; Seo, Bommie Florence; Kwon, Ho; Jung, Sung No

doi:10.1016/j.bjps.2018.02.005

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…It has been observed that patients with unsuccessful replantation at this level can be left for secondary healing and obtain acceptable results without a second surgical intervention. In terms of injury mechanism, success for guillotine-type injury was found to be significantly higher, similar to the findings of previous studies 2 8 14 .…”

Section: Discussionsupporting

confidence: 90%

“…Available studies on this topic suggest the application of k-wire for this purpose [1,16,25]. In a single randomized controlled trial focused on this topic, it was reported that bone fixation was not required [14]. Furthermore, the authors suggested that not using k-wire for this purpose contributed to increased venous drainage from the bone medulla.…”

Section: Discussionmentioning

confidence: 99%

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Supermicrosurgical Experience pertaining to Replantation of Tamai Zone 1 Fingertip Amputations

Pamuk¹

2022

Handchir Mikrochir Plast Chir

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With the advent of supermicrosurgery, the replantation of very distal finger amputations has become possible. The choice between replantation or flap surgeries in the treatment of Tamai Zone I finger amputations continues to be a matter of debate. This study aims to evaluate replantation results in Tamai Zone 1 finger amputations. The demographic characteristics and clinical results of 39 patients undergoing replantation for a Tamai Zone 1 finger amputation between 2018 and 2021 were retrospectively analyzed. The Cold Intolerance Severity Score (CISS), two-point discrimination test (2-PD) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) were calculated and recorded after a minimum follow-up period of 6 months. The great majority of patients were males (92.3%, n=36) who had suffered the injuries during work accidents (89.7%, n=35). The socioeconomic status of the patients showed a homogeneous distribution. Replant survival was achieved in 69.2% (n=27) of all fingers. The duration of the surgical procedure in patients who underwent vein repair was significantly longer (p<0.001). However, there was no significant relationship between vein repair and survival rate (p=0.348). This study shows that replantation is a surgical intervention that should be given priority in patients with Tamai Zone 1 amputations. In most cases of unsuccessful replantation, secondary recovery results are also acceptable. Future studies with larger case series are needed.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Supermicrosurgical Experience pertaining to Replantation of Tamai Zone 1 Fingertip Amputations

Pamuk¹

2022

Handchir Mikrochir Plast Chir

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“…Fortunately, this challenging procedure is currently performed widely in both academic and community practice settings due to increased access to microsurgery training and education opportunities, to restore not only circulation, but also function, sensation and cosmetic appearance. [1][2][3][4] Objectives: This study aims to evaluate the clinical results and experiences in a community hospital regarding procedures for the replantation and revascularization of fingers.…”

mentioning

confidence: 99%

A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers

Gürbüz

Yontar

2021

Jt Dis Relat Surg

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Objectives: This study aims to evaluate the clinical results and experiences in a community hospital regarding procedures for the replantation and revascularization of fingers. Patients and methods: Between June 2015 and December 2019, a total of 58 patients (51 males, 7 females; mean age: 33.4±6.3 years; range, 23 to 46 years) who were followed after total and/or subtotal amputation and replantation were retrospectively analyzed. The patients were evaluated at nine months in terms of cold intolerance, static two-point discrimination, and functional results using the range of motion (ROM) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Results: The majority of the patients presented with work-related injuries (70%), most commonly by the mechanism of guillotine (64%), and to the dominant hand (76%) and the third finger (36%) most frequently. The overall success rate of digit salvage was 72.9% (n=51). Of 19 digits with unsuccessful surgical outcomes, seven were from total and 12 were from subtotal amputations. In the long-term, cold intolerance was observed in 14 patients (24.1%) according to the cold intolerance severity scale. The mean static two- point discrimination value was 6.0±0.7 mm and the mean QuickDASH score was 22.3±5.0. The mean ROM measured at nine months after surgery in the metacarpophalangeal and interphalangeal joints of the third and fourth digits was significantly lower than that in the others (p<0.05). Conclusion: The predictors of survival of a replanted digit indicated in this study can be used as a guide and decision-making aid for any attempts for replantation.

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“…Успешно выполненная реплантация пальцев кисти не гарантирует благоприятный исход [27]. Данный метод являет-ся перспективным и заслуживает пристального внимания.…”

Section: рис 8 анатомия артериальных сосудов кончика пальцевunclassified

Replantation fingertip without venous anastomoses in children

et al. 2021

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Objective. Traumatic complete and partial finger amputations are rare in comparison with adults. There are significant differences between mechanism of trauma, principles of treatment children with this type of injury in comparison with adults.Clinical case. A 15-years old child suffered from injury by axe, which caused the traumatic fingertip amputation of III and IV digits of his right hand. Replantation of both amputated parts was performed. Arteries and nerves were repaired with no veins anastomosed. As a result - survival of replanted parts.Discussion. A submillimeter diameter of vessels and potential venous congestion are basic problems that a surgeon deal with when perform the replantation of fingertips. Respectively, a difficulty in post-operative care of patient appears.Conclusion. Replantation of amputated part of finger is a golden standard of treatment of children with a described type of injury. The correct deliverance of amputated parts, the shortest time of ischemia as possible, a qualitive operation and post-operative care play an important role in successful survival of the replanted segments.

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A prospective randomised comparison of fixation methods in Tamai's zone I amputation

Cited by 7 publications

References 21 publications

Supermicrosurgical Experience pertaining to Replantation of Tamai Zone 1 Fingertip Amputations

Supermicrosurgical Experience pertaining to Replantation of Tamai Zone 1 Fingertip Amputations

A four-year community hospital experience regarding procedures for the replantation and revascularization of fingers

Replantation fingertip without venous anastomoses in children

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