Replantation for multiple digit amputations: A retrospective analysis of the clinical results

Summary Purpose Replantation of multi-digit amputations is difficult to perform due to severe damage to the digits, prolonged operative time, and ischemia. This study aimed to report the clinical results of multi-digit replantation. Methods A retrospective case series of 34 digits belonging to12 consecutive patients who underwent multi-digit replantation was conducted. Patients with injury in at least one or more amputated digits proximal to the insertion of the flexor digitorum superficialis tendon were included. The mean follow-up duration was 18.1 months. The number of amputated fingers, mechanism and zone of injury, survival rate, and clinical outcomes, including range of motion, grip strength, and sensory recovery, at the final follow-up were reviewed and analyzed. Results The mean number of amputated fingers per patient was 3.1. Complete survival was achieved in 27 of 31 fingers (87.1%). The mean final percentage of total active motion of injured digits was 47.0%, and the mean percentage of grip strength was 45.9% of the contralateral uninjured side. The comparison between patients with two and three amputated fingers showed that there was no significant difference in both survival rates and functional outcomes. Conclusions The results showed that both the survival rates and functional outcomes of multi-digit replantation were as good as those of single-digit replantation, and there was no significant difference in both survival rates and functional outcomes between patients with two and three amputated fingers. These results suggested that all multi-digit replantations should be performed regardless of the number of injured digits or amputation zones.