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Pediatric Digit Replantation Following Traumatic Amputation: Nationwide Analysis of Patient Selection, Outcomes, and Cost.

Publication ,  Journal Article
Li, NY; Kleiner, JE; Harris, AP; Goodman, AD; Katarincic, JA
Published in: Hand (N Y)
September 2021

Background: Indications for replantation following traumatic digit amputations are more liberal in the pediatric population than in adults, but delineation of patient selection within pediatrics and their outcomes have yet to be elucidated. This study uses a national pediatric database to evaluate patient characteristics and injury patterns involved in replantation and their outcomes. Methods: The Healthcare Cost and Utilization Project Kid's Inpatient Database was queried for traumatic amputations of the thumb and finger from 2000 to 2012. Participants were separated into those who underwent replantation and those who underwent amputation. Patients undergoing replantation were further divided into those requiring revision amputation and/or microvascular revision. Patient age, sex, insurance, digit(s) affected, charges, length of stay, and complications were extracted for each patient. Results: Traumatic digit amputations occurred in 3090 patients, with 1950 (63.1%) undergoing revision amputation and 1140 (36.9%) undergoing replantation. Younger patients, those with thumb injuries, females, and those covered under private insurance were significantly more likely to undergo replantation. Cost, length of stay, and in-hospital complications were significantly greater in replantation patients than in those who had undergone amputation. Following replantation, 237 patients (20.8%) underwent revision amputation and 209 (18.3%) underwent vascular revision, after which 58 required revision amputation. Risk of revision following replantation involved older patients, males, and procedures done recently. Conclusions: Pediatric patients who underwent replantation were significantly younger, female, had thumb injuries, and were covered by private insurance. Our findings demonstrate that in addition to injury factors, demographics play a significant role in the decision for finger replantation and its outcomes.

Duke Scholars

Published In

Hand (N Y)

DOI

EISSN

1558-9455

Publication Date

September 2021

Volume

16

Issue

5

Start / End Page

612 / 618

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Replantation
  • Pediatrics
  • Patient Selection
  • Orthopedics
  • Male
  • Humans
  • Female
  • Child
  • Amputation, Traumatic
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Li, N. Y., Kleiner, J. E., Harris, A. P., Goodman, A. D., & Katarincic, J. A. (2021). Pediatric Digit Replantation Following Traumatic Amputation: Nationwide Analysis of Patient Selection, Outcomes, and Cost. Hand (N Y), 16(5), 612–618. https://doi.org/10.1177/1558944719873150
Li, Neill Y., Justin E. Kleiner, Andrew P. Harris, Avi D. Goodman, and Julia A. Katarincic. “Pediatric Digit Replantation Following Traumatic Amputation: Nationwide Analysis of Patient Selection, Outcomes, and Cost.Hand (N Y) 16, no. 5 (September 2021): 612–18. https://doi.org/10.1177/1558944719873150.
Li NY, Kleiner JE, Harris AP, Goodman AD, Katarincic JA. Pediatric Digit Replantation Following Traumatic Amputation: Nationwide Analysis of Patient Selection, Outcomes, and Cost. Hand (N Y). 2021 Sep;16(5):612–8.
Li, Neill Y., et al. “Pediatric Digit Replantation Following Traumatic Amputation: Nationwide Analysis of Patient Selection, Outcomes, and Cost.Hand (N Y), vol. 16, no. 5, Sept. 2021, pp. 612–18. Pubmed, doi:10.1177/1558944719873150.
Li NY, Kleiner JE, Harris AP, Goodman AD, Katarincic JA. Pediatric Digit Replantation Following Traumatic Amputation: Nationwide Analysis of Patient Selection, Outcomes, and Cost. Hand (N Y). 2021 Sep;16(5):612–618.
Journal cover image

Published In

Hand (N Y)

DOI

EISSN

1558-9455

Publication Date

September 2021

Volume

16

Issue

5

Start / End Page

612 / 618

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Replantation
  • Pediatrics
  • Patient Selection
  • Orthopedics
  • Male
  • Humans
  • Female
  • Child
  • Amputation, Traumatic