Summary
Replantation is now firmly established as a viable treatment option in traumatic limb
amputation, yet there are few long-term studies describing the functional outcome
of these cases. The purpose of the present study was to evaluate long-term results
in a population of such patients to determine overall success and patient satisfaction.
Since 1981, twenty macro-replants involving nineteen patients have been performed
in our unit. All patients were reviewed by means of case note analysis, patient questionnaire,
and follow-up clinical evaluation for functional outcome using the Tamai scoring system.
Acute limb salvage was successful in 18/20 (90%) cases. One patient is still undergoing
secondary reconstructive surgery and was unable to be assessed for final outcome leaving
17 replanted limbs that underwent full functional assessment. Overall functional results
were good in 7/17 (41%) limbs, fair in 7/17 (41%) and poor in 3/17 (18%). The majority
of patients (12/17) claimed to be highly or well satisfied with their outcome and
eleven have returned to work since their injury. The current study of major limb replantation
demonstrates favorable or acceptable long term functional outcomes in the majority
of cases. High patient satisfaction rates even where results were poor emphasise the
positive psychological impact of successful replantation.
Keywords
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References
- Replantation of several arms.JAMA. 1964; 189: 716-722
- Experience with reanastomosis of the amputated thumb.Seikei Geka. 1967; 4: 403-404
- Principles of evaluation and results in microsurgical treatment of major limb amputations. A follow-up study of 26 consecutive cases 1978–1987.Scand J Plast Reconstr Surg Hand Surg. 1990; 24: 75-80
- Long-term follow-up of hand function after digit replantation.Ann Plast Surg. 1993; 31: 322-326
- Twenty years' experience of limb replantation–review of 293 upper extremity replants.J Hand Surg Am. 1982; 7: 549-556
- Results of 1018 digital replantations in 552 patients.Injury. 2000; 31: 33-40
- Digital replantation and amputation - comparison of function.J Hand Surg Am. 1982; 7: 183-189
- Major limb replantation: a Thai experience.Annal Acad Med Singapore. 1995; 24: 82-88
- Actualities in big segments replantation surgery.J Plast Reconstr Aesthet Surg. 2007; 60: 849-855
- Technical considerations and functional outcome of 22 major limb replantations.J Hand Surgery Eur Vol. 2007; 32: 488-502
- Indications and selection for digital amputation and replantation.J Hand Surg Br. 2001; 26: 572-581
- Indications for replantation in the adult upper extremity.Occup Med. 1989; 4: 525-538
Article info
Publication history
Published online: April 05, 2012
Accepted:
January 23,
2012
Received:
June 19,
2011
Identification
Copyright
© 2012 Published by Elsevier Inc.
