Replantation or revascularisation injuries in children: Incidence, epidemiology, and outcome

Lindfors, Nina; Marttila, Ilkka

doi:10.3109/2000656x.2012.700012

Cited by 15 publications

(5 citation statements)

References 12 publications

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“…With the development of microsurgical technology and the breakthrough of age factors and disconnection level of severed finger replantation, the survival rate of severed finger replantation in infants and young children is also higher and higher. Postoperative bed braking and baking lamp insulation have become the consensus of hand surgeons [ 13 , 14 ]. Due to the specificity of this group of infants, their postoperative compliance is poor.…”

Section: Introductionmentioning

confidence: 99%

Clinical Application of Restrictive Brace Combined with Psychological Intervention after Replantation of Severed Fingers in Children

Chen¹,

Wang²,

Wang³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. After replantation of severed fingers in infants, the utility model patent upper limb restrictive brace-assisted bed rest braking, combined with psychological intervention, can alleviate children’s anxiety, so as to reduce the occurrence of vascular crisis. Methods. The study period was from April 2015 to July 2018. In this paper, 30 children with finger injuries in hand surgery in the CIS electronic medical record system of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were selected as the research objects. Replantation was performed in 30 infants with severed fingers. Among them, 15 cases were applied with the method of aircraft chest arm gypsum splint combined with sedative drug braking and the utility model patented product upper limb restrictive brace fixation-assisted bed rest braking, and the method of psychological intervention was applied at the same time. Results. Among the 15 fingers in the control group, 6 had vascular crisis and 1 in the experimental group. The incidence of vascular crisis in the experimental group was lower, and the difference between the two groups was statistically significant ( P < 0.05 ). The patients were followed up for 9~18 months, with an average of 9.72 ± 1.07 months. In the control group, 15 cases of severed fingers survived, and there were 13 cases of replantation finger necrosis in 2 cases of intractable arterial crisis. In the experimental group, 14 cases of severed fingers survived in 15 cases and there was 1 case of replanted finger necrosis in intractable arterial crisis after operation. There was no significant difference in the survival rate between the two groups ( P > 0.05 ). In addition, the replanted finger function was evaluated. In the control group, 9 cases were excellent, 4 cases were good, and 1 case was fair. In the experimental group, 14 cases were excellent, 1 case was good, and 0 case was fair. The functional evaluation of the experimental group was better than that of the control group, and the difference between the two groups was statistically significant ( P < 0.05 ). Conclusion. For infants after replantation of severed fingers, the application of the utility model patented product upper limb restrictive brace can effectively make up for the insufficient fixation of aircraft chest arm gypsum splint, reduce the occurrence of vascular crisis, and assist children in bed. In addition, the application of psychological intervention can reduce children’s postoperative crying and is conducive to children’s postoperative recovery.

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Section: Introductionmentioning

confidence: 99%

Clinical Application of Restrictive Brace Combined with Psychological Intervention after Replantation of Severed Fingers in Children

Chen¹,

Wang²,

Wang³

et al. 2022

Computational and Mathematical Methods in Medicine

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“…The second is the size of vessels specially that of the vein which is more delicate and smaller than that of the adult. The third is the lack of child cooperation and awareness which make it difficult for rehabilitation and followup [7,8]. In this study the number of involved children was 6, their average age was 9 years.…”

Section: Discussionmentioning

confidence: 78%

“…Because of the lack of cooperation between the children on one hand and both of the surgeon and the parents on the other hand, the functional outcome of digital replantation in children is lower than that of adult. Lindfors and Marttila [7] presented 29 patients with 38 finger injuries. Eight had a severe amputation injury.…”

Section: Discussionmentioning

confidence: 99%

Finger Replantation: Good and Bad Results

Salama

Soror

Ali

et al. 2020

Egyptian Journal of Orthopedic Research

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There are different causes for finger amputation. Causes are starting from clean cut amputation up to avulsion. There are many factors affecting the results of finger replantation, as cause of injury, age of the patient, level of amputation, time passed after injury, methods for preservation of the amputated part, trained surgeons, and surgical equipments. Other factors affect the results of finger replantation are number of digital amputation, surgeon comfortability, and patient cooperation. This study included 38 patients presented by amputation of 57 fingers. The average age was 23 years old. The main cause was machine injury. The dominant hand was the right hand. The dominant finger was the thumb. The level of injury was proximal to the proximal interphalangeal joint in most of cases. The average time passed between injury and replantation was 2 hours. The average time of surgery for one digit replantation was 4 hours. The principles of treatment was exploration of the neurovascular and tendons in the amputated digit initially then that of the stump. The order of treatment was bone fixation by 2 kirschner wire, digital artery, digital vein, flexor tendon, digital nerve, extensor tendon. Skin closure should be loose. The average follow up was 58 months. All fingers have been survived except five. The average time for bone union was 8 weeks. According to Chen's criteria, the overall results were classified as grade I (excellent) in 20 cases, grade II (good) in 16 cases and grade III (fair) in 2 cases. The tendon function was excellent in 20 fingers, good in 26 fingers fair in 3 fingers, poor in 2 fingers and failure in 6 fingers. The 2 point discrimination was 6 mm in 9 fingers, 7-10 mm in 29 fingers, and 12-15 mm in 13 fingers. The mean grip and pinch strengths were 80 % and 85% respectively compared to contralateral hand. All of patient had returned to their normal daily activities. Finally, finger replantation is not an easy job and it is considered as challenging procedure even for the specialist. I think that many factors affecting the results of finger replantation have not been discovered yet.

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“…В мировой литературе имеются сведения о том, что 30-40% реплантаций пальцев кисти у детей являются успешными. Это связано с расширенными показаниями к реплантации по сравнению со взрослыми, соответственно, у детей предпринимается больше попыток данного вида вмешательства [12]. За последние два года в отделении микрохирургии ДГКБ им.…”

Section: а бunclassified

“…Согласно принципам современной детской микрохирургии, при отчленении сегмента конечности ребенка, любая ампутированная часть должна быть подвергнута реплантации [9]. В связи с этим лишь 40-60% попыток реплантаций являются успешными [10][11][12]. В то же время, исходы успешных случаев реплантации у детей более благоприятны, чем у взрослых, так как у детей восстановление нервов и регенерация покровных тканей протекают быстрее, наблюдается менее грубое формирование рубцов [13].…”

Section: Introductionunclassified

Replantation fingertip without venous anastomoses in children

et al. 2021

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Objective. Traumatic complete and partial finger amputations are rare in comparison with adults. There are significant differences between mechanism of trauma, principles of treatment children with this type of injury in comparison with adults.Clinical case. A 15-years old child suffered from injury by axe, which caused the traumatic fingertip amputation of III and IV digits of his right hand. Replantation of both amputated parts was performed. Arteries and nerves were repaired with no veins anastomosed. As a result - survival of replanted parts.Discussion. A submillimeter diameter of vessels and potential venous congestion are basic problems that a surgeon deal with when perform the replantation of fingertips. Respectively, a difficulty in post-operative care of patient appears.Conclusion. Replantation of amputated part of finger is a golden standard of treatment of children with a described type of injury. The correct deliverance of amputated parts, the shortest time of ischemia as possible, a qualitive operation and post-operative care play an important role in successful survival of the replanted segments.

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Replantation or revascularisation injuries in children: Incidence, epidemiology, and outcome

Cited by 15 publications

References 12 publications

Clinical Application of Restrictive Brace Combined with Psychological Intervention after Replantation of Severed Fingers in Children

Clinical Application of Restrictive Brace Combined with Psychological Intervention after Replantation of Severed Fingers in Children

Finger Replantation: Good and Bad Results

Replantation fingertip without venous anastomoses in children

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