A Systematic Review of Outcomes of Revision Amputation Treatment for Fingertip Amputations

Abstract

Purpose The purpose of this study was to conduct a systematic review of outcomes of fingertip revision amputation for fingertip amputation injuries in the Englishlanguage literature to provide best evidence of functional outcomes.

A Systematic Review of Outcomes and Complications of Primary Fingertip Reconstruction Using Reverse-Flow Homodigital Island Flaps

“…On average, the ROM of the DIP joint after reconstruction was 63°, which is within the normal range (60°-90°) and return-to-work time was 7 weeks, which is regarded as early recovery [37]. These outcomes were similar to the outcomes reported by Wang et al [36].…”

“…Alagoz et al [7] (n = 14), Yazar et al [8] (n = 70), and Kayalar et al [9] (n = 6) reported excellent sensibility outcomes (static 2PD 6.5, 5.7, and 4.3 mm, respectively) using sensate flaps. The sensibility outcome was similar to that reported by Sebastin et al [35], and slightly weaker than the outcome reported by Wang et al [36]. On average, the ROM of the DIP joint after reconstruction was 63°, which is within the normal range (60°-90°) and return-to-work time was 7 weeks, which is regarded as early recovery [37].…”

“…Yildirim et al [12] (n = 24), Adani et al [11] (n = 11), and Acar et al [13] (n = 22) reported a high prevalence of cold intolerance (42, 27, and 23 %, respectively), whereas Han et al [6] (n = 11) and Momeni et al [14] (n = 11) reported no incidence of cold intolerance. However, the prevalence of cold intolerance following fingertip reconstruction using reverse-flow homodigital island flaps is better than the prevalence of cold intolerance reported by Wang et al [36] (24 % experienced moderate to severe). In addition, Han et al [10] reported the largest number of fingertip reconstructions using reverse-flow homodigital island flaps.…”

“…Complications include nail deformities [24 % of the patients (n = 653)] and pulp atrophy [14 % of the patients (n = 639)]. In contrast, Wang et al [36] in their systematic review concluded that the revision amputation treatment for fingertip amputation can achieve normal sensibility and satisfactory range of motion. His review included studies that reported outcomes of primary revision amputation following distal digital amputation, where treatment included open treatment, primary closure, full-thickness skin grafting, local, or regional flap closure.…”

Improved Abdomen Hypodermic Embedding for Salvage of the Amputated Fingertip from Tip to Lunula (Tamai Zone Ⅰ)

“…Revision amputation is a simple and practical method. It can achieve almost normal sensibility and satisfactory motion [6]. However, it also has many disadvantages, such as frequent cold intolerance [7], painful neuroma formation [8], shortening of the ngers and poor appearance.…”