Indications, functional results and patient satisfaction after isolated second ray resection following traumatic injury: A retrospective review of 25 patients
| Autor: | H. Chasseuil, F.-M. Leclère, H. Choughri, N. Bertheuil, Amirouche Dahmam, Philippe Pelissier, Benoit Chaput, M. Alabdulkareem |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030230 surgery Amputation Surgical Resection 03 medical and health sciences Grip strength Young Adult 0302 clinical medicine Patient satisfaction Amputation Traumatic Finger Injuries medicine Humans Pinch Strength Orthopedics and Sports Medicine Aged Retrospective Studies 030222 orthopedics Retrospective review business.industry Rehabilitation Amputation Stumps Index finger Middle Aged Surgery Traumatic injury medicine.anatomical_structure Amputation Patient Satisfaction Female business Second ray |
| Zdroj: | Hand surgeryrehabilitation. 39(2) |
| ISSN: | 2468-1210 |
| Popis: | Amputation of the second ray is a surgical treatment option when reconstruction and/or reimplantation fail. The aim of our study was to review the outcomes after transmetacarpal resection of the second ray following a post-traumatic injury and to assess indications, functional outcomes, and patient satisfaction. Between January 2003 and December 2013, 25 patients (6 women and 19 men with a mean age of 51 years) underwent transmetacarpal resection of their second ray after a post-traumatic injury. Sixteen patients were right-handed and 9 were left-handed. Injuries involved the dominant hand in 14 cases (60%). In order to differentiate patients with preserved index finger length preoperatively from those with a shorter, amputated index finger stump, patients were divided into 2 groups. Group 1 included those with an "intact finger" and Group 2 included patients with an "amputated stump". Data collection, including patient satisfaction and functional outcomes, was performed at 83 months postoperative on average. Average length of follow-up was 7.0±1.0 years (range 5-12 years). Group 1 (intact finger) and 2 (amputated stump) included 15 and 10 patients, respectively. Six patients (24%) had primary ray amputation and 19 (76%) had secondary ray amputation. No surgical revision was necessary. In Group 1, the indications were purely functional in all but two cases, whereas aesthetic indications played a role in all patients in Group 2. The average total time off work was 3 months. There was no difference between Group 1 and 2 (P>0.05). However, patients with primary ray resection averaged 10 weeks of lost work compared to 17 weeks for secondary amputation. There was no functional difference between Groups 1 and 2. Scores for cosmetic appearance and patient satisfaction were higher in Group 2. In certain specific situations after complex hand trauma, transmetacarpal amputation of the second ray is indicated as soon as possible, in order to reduce the time off work. Patient satisfaction following this surgical procedure is high, especially in groups with amputated stumps. A 30% decrease in pinch and grip strength is the rule. No secondary surgery is normally required. |
| Databáze: | OpenAIRE |
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