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Gender
0%
9/2513
Anastamosing the proximal profundus tendon stump to the superficialis tendon of the amputated digit
1%
33/2513
Regular cigarette smoking
22%
552/2513
Utilization of composite skin and subcutaneous vein graft
27/2513
Mechanism of digit amputation injury
74%
1871/2513
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The Level 2 study by Waikakul et al is a cohort of 552 patients that underwent 1018 digit replantation. Mechanism of injury was the most important factor influencing the survival rate with an odds ratio of 46.3. Specifically, avulsion, degloving and extensive crushed amputation resulted in a low survival rate and poor functional outcome. Cigarette smoking and male gender were associated with worse results but not to the degree of the mechanism of injury. Utilization of composite skin and subcutaneous vein grafts as well as connecting the profundus to the superficialis at the anastomoses correlated to better outcomes. After the operation, 329 of 946 survived digits (34.7%) in 180 patients (35.4%) needed further reconstructive surgery to improve their function. Tenolysis was the most common procedure followed by staged tendon grafting and capsulotomy. The review article by Wang found that tendon procedures, specifically tenolysis, accounted for 47.2% secondary surgeries following digit replantation.
3.4
(19)
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