THE POCKET METHOD GIVES POOR RESULTS WHEN USED FOR FINGERTIP AMPUTATIONS WITH BONY FRAGMENTS

Abstract

Background: The aim of this study is to investigate the mid-term results of subdermal pocket replantation without vessel repair on fingertip amputation cases with bone fragments. Methods: In 2018-2019, nine patients’ eleven fingers whose fingertip amputation could not be repaired and be aplied sub dermal pocketing were included in the study. Satisfaction level, range of motion, length and survival rate, two-point static discrimination and Semmes Weinstein monofilament test were applied. Results: All of the patients included in the study were male and the mean age was 35.2 ± 13.5 years. The mean time be tween insertion and removal of the finger in the pocket is 16.45 ± 2.42 (14-21) days. The median of SMWT was 2.83 (2.83 – 6.65) and the mean of S2PD was 3.62 ± 0.38 (2.00 – 6.00) mm. The mean score of satisfaction was 65.9 ± 27.9 (0 – 100) out of hundred. Three patients’ three fingers survived and this patients were named as group A, and the other 6 patients (8 fingers) were named as group B. The average survival rate of three patients was 71.7 ± 33.2%. There was no statistically significant difference between groups in terms of age, waiting time in the pocket, SWMT, S2PD and satisfaction scores. Conclusions: Although pocket replantation method is an easy method to apply, it does not show perfect results in cases with bone fragments. It seems to be a viable method for providing venous drainage in fingertip amputations where artery repair can be performed but vein repair cannot be performed.