Thumb replantation or not?

Abstract

Over a three-year period 14 consecutive cases of amputated thumbs, 10 complete and 4 incomplete, were replanted/revascularized. Eight thumbs (57%) survived. These cases were compared with a control group, in which replantation had failed or had not been attempted. The control group was chosen to be as similar as possible with respect to thumb amputation level, type of trauma, age, occupation and sex. Costs for hospital care, duration of sick leave and disability rate were calculated. Hand function was estimated as the ROM of the thumb, power of pinch and grip, two-point discrimination and ability to perform a standardized hand function test (Sollerman). It was concluded that replantation yields better functional and social results than alternative treatment of thumb amputation at similar costs.