Proximal interphalangeal replantation with arthrodesis facilitates favorable esthetics and functional outcomeReport as inadecuate

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Journal of Trauma Management and Outcomes

, 9:7

First Online: 27 October 2015Received: 08 November 2014Accepted: 20 October 2015


PurposeManagement of finger amputations of the proximal interphalangeal PIP joint is still controversial. Regrettably, injured PIP joints seldom regain normal active motion; thus, many investigators recommend revision amputation with skeletal injury at or proximal to the PIP joint. We report the functional outcome of patients with replantation or revascularization following complete or incomplete amputations of the PIP joint.

MethodsA total of 15 digital replantations or revascularization were performed on 11 patients 9 males and 2 females, age, 26–69 years with severe finger injuries at the PIP joint at our Medical Center from 2010 through 2012. Seven patients with 10 complete amputations underwent replantations, and 4 with 5 incomplete avulsion amputations underwent revascularization. PIP arthrodesis was performed in all cases. Routine postoperative evaluation was performed in 13 successfully treated patients.

ResultsThe 13 successfully treated cases were tracked over a follow-up of 12 to 55 months. Arthrodesis of PIP caused significantly lower total active range of motion TAM; 85–120°. The mean DASH score was 37-100 range: 10–64 points. Although mobility is poorer in PIP replantations, adequate PIP joint fixation improves DASH score and hand function.

ConclusionsPIP replantation along with arthrodesis at a functional position for a finger amputation should be performed when the patient wishes to undergo replantation, which facilitates patient satisfaction.

KeywordsFinger amputation Finger avulsion Hand surgery outcomes Replantation Revascularization AbbreviationsPIPProximal interphalangeal

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Author: Masaki Fujioka - Kenji Hayashida


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