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Digital replantation at the level of the distal interphalangeal joint and the distal phalanx.

Publication ,  Journal Article
Goldner, RD; Stevanovic, MV; Nunley, JA; Urbaniak, JR
Published in: J Hand Surg Am
March 1989

Forty-two complete, single digit amputations at the level of the distal interphalangeal joint or distal phalanx are reviewed. Viability was 81%. Operative time averaged 4.6 hours. Average age of patients was 28 years and 90% were male. Forty-eight percent of the amputations involved the thumb; 79% were at the distal interphalangeal joint and 21% were more distal. One artery was repaired in 64% of replantations, two or three veins were repaired in 61%, and veins grafts were used in 19% of cases. Sixty-nine percent of the crush-avulsion injuries succeeded compared with 89% of lacerations. Two-point discrimination averaged 10 mm and proximal interphalangeal motion averaged 91 degrees. Patients returned to work an average of 2.5 months after replantation and none required additional procedures. The average total cost of treatment was $7500.00. Compared with conventional procedures, disadvantages of replantation at or distal to the distal interphalangeal joint are that it does require microsurgical training, initial operating time is longer, and it is more expensive. Advantages are that it is a one-stage procedure that gives good distal soft tissue coverage, adequate sensibility without painful neuroma, good metacarpophalangeal and proximal interphalangeal joint motion; it preserves the nail, maintains digit length, is cosmetically pleasing, and the patient is satisfied.

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Published In

J Hand Surg Am

DOI

ISSN

0363-5023

Publication Date

March 1989

Volume

14

Issue

2 Pt 1

Start / End Page

214 / 220

Location

United States

Related Subject Headings

  • Replantation
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Finger Injuries
  • Female
  • Consumer Behavior
  • Child, Preschool
  • Child
 

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Goldner, R. D., Stevanovic, M. V., Nunley, J. A., & Urbaniak, J. R. (1989). Digital replantation at the level of the distal interphalangeal joint and the distal phalanx. J Hand Surg Am, 14(2 Pt 1), 214–220. https://doi.org/10.1016/0363-5023(89)90009-9
Goldner, R. D., M. V. Stevanovic, J. A. Nunley, and J. R. Urbaniak. “Digital replantation at the level of the distal interphalangeal joint and the distal phalanx.J Hand Surg Am 14, no. 2 Pt 1 (March 1989): 214–20. https://doi.org/10.1016/0363-5023(89)90009-9.
Goldner RD, Stevanovic MV, Nunley JA, Urbaniak JR. Digital replantation at the level of the distal interphalangeal joint and the distal phalanx. J Hand Surg Am. 1989 Mar;14(2 Pt 1):214–20.
Goldner, R. D., et al. “Digital replantation at the level of the distal interphalangeal joint and the distal phalanx.J Hand Surg Am, vol. 14, no. 2 Pt 1, Mar. 1989, pp. 214–20. Pubmed, doi:10.1016/0363-5023(89)90009-9.
Goldner RD, Stevanovic MV, Nunley JA, Urbaniak JR. Digital replantation at the level of the distal interphalangeal joint and the distal phalanx. J Hand Surg Am. 1989 Mar;14(2 Pt 1):214–220.
Journal cover image

Published In

J Hand Surg Am

DOI

ISSN

0363-5023

Publication Date

March 1989

Volume

14

Issue

2 Pt 1

Start / End Page

214 / 220

Location

United States

Related Subject Headings

  • Replantation
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Finger Injuries
  • Female
  • Consumer Behavior
  • Child, Preschool
  • Child