Microsurgical Finger Replantation in Hanoi, Vietnam: Our First Experience

Abstract

In this retrospective study, the author reports on preliminary results of finger replantations performed in the Department of Traumatology, Orthopaedics and Hand Surgery at Central Hospital 108, No. 1 Tran Hung Dao, Hanoi, Vietnam between September 1999 and December 2002. Forty-six amputated digits involving thirty-two complete and fourteen incomplete fingers were replanted and subsequently evaluated. The majority of the amputations was caused by avulsing or crushing injuries (76 %), with the left hand being predominantly affected (78.3 %). The overall success rate of finger replantation was 91.3 %. Secondary supplemental operations were performed in 8/42 (19 %) of the surviving digits, including seven tenolyses and one repeated osteosynthesis. The combined postoperative functional outcomes rated either as "good" or "fair" were 90.5 %, based on an average follow-up period of 18 months. One surviving replant was amputated one year later due to lost function and paraesthesia. We concluded from the study that digit replantations, especially multiple amputations, are often successful and it is always worthwhile to attempt to restore function as well as the normal appearance of the hand and digits. Despite the limited postoperative movement and less than normal level of sensation compared to uninjured counterparts, most individuals with surviving replanted digits following amputations can actively and effectively perform normal tasks without instability or pain.

Reporting Outcomes and Outcome Measures in Digital Replantation: A Systematic Review

“…of later reconstruction required 29,31,38,42,44 4. Infection rate 43 5. Units of blood transfused 39 6.…”

“…Depression 62,64 4. Patient satisfaction 21,28,39,41,43,46,58,61,64 5. ADLs/disability 27,46,60,64,68,69 6.…”

“…Cold sensitivity 16,[18][19][20]24,27,37,39,41,65 3. Pain 17,19,24,31,41,43,45,47,61,64,68,70 4. Paraesthesia 39,41,43,61 5.…”

“…Time in hospital 16,17,21,25,33,[35][36][37][38][39][40]46,60,70 2. Time in OR 21,33,37,38,40,41,43,45 3. Time in F/U 24,31,36,37,59,60 4.…”

“…Congestion (yes/no) 32,40 16,19,20,24,27,37,61,63 1. S2PD 9,20,23,[26][27][28][29]31,39,41,43,47,53,57,[60][61][62][63] 16,17,23,25,33,[35][36][37][38][39][40][41]43,45,[58][59][60] N N 2. Monetary currency 37,38,46 N N Table 7 Hand function outcome measures…”