Indications for replantation and factors that predict success.

Autor: Bregman D; Department of Orthopedics, University of Southern California, Los Angeles, California, USA. danabregmanmd@gmail.com., Nicholson L; Department of Orthopedics, University of Southern California, Los Angeles, California, USA.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 Oct; Vol. 34 (7), pp. 3661-3668. Date of Electronic Publication: 2023 Aug 18.
DOI: 10.1007/s00590-023-03671-2
Abstrakt: Since the advent of replantation techniques, there has been uneven progress in terms of success-even considering whether success is defined as continued perfusion of the digit or long term functional outcomes. Early enthusiasm and success have not been maintained despite increasing familiarity with microsurgical techniques and greater understanding of how to optimize outcomes for the individual components of replantation such as tendon repair, nerve repair, and osteosynthesis. Practitioners participating in the care of patients undergoing replantation should be familiar with the history and current understanding of both the indications and contraindications for the procedure, post-operative rehabilitation, and factors contributing to functional outcomes. A review of the literature from the first publications on the topic demonstrates evolution in practice and understanding of which patients should be indicated for replantation. Indications can be considered in three broad categories: injury factors, patient factors, and care context factors. These factors intersect with one another and can inform the surgeon pre-operatively regarding the most likely outcome for a given patient. This insight is critical to discuss pre-operatively with the patient in order to make a shared decision about how to manage their injury.
(© 2023. The Author(s).)
Databáze: MEDLINE
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