Abstract
Purpose To assess the long-term functional and clinical outcomes of patients who have undergone replantation after radiocarpal amputation. Methods We performed a retrospective review of radiocarpal joint amputations at a level 1 trauma center over a 13-year period. Medical records of patients treated with replantation were queried for injury data, operative reports, complications, and clinical progress. Patients who met inclusion criteria were contacted for long-term follow-up. We measured total active motion of each digit, strength (grip and pinch), and 2-point discrimination. Functional outcomes were assessed with Disabilities of Arm, Shoulder, and Hand score, Mayo Wrist Score, Patient-Rated Wrist Evaluation, and Michigan Hand Questionnaire. Descriptive statistics were calculated, including frequencies for categorical variables and means and ranges for continuous variables. Results Six patients met the inclusion criteria. The mean age was 36 years (range, 26-50 y). Five patients were available at a mean follow-up of 3.9 years (range, 1.0-6.9 y). Compared with the contralateral uninjured extremity, total active motion of the hand was 38% (range, 26% to 59%) and grip strength was 9% (range, 0% to 18%). Neither tip nor key pinch was present. Mean 2-point discrimination was 10.6 mm (range, 8-12 mm). All mean outcome scores indicated moderate disability, including Disabilities of Arm, Shoulder, and Hand (76; range, 45-82), Mayo Wrist Score (23; range, 5-50), Patient-Rated Wrist Evaluation (86; range, 56-98), and Michigan Hand Questionnaire (27; range, 15-55). Two patients were able to return to work and 3 were permanently disabled. All patients were satisfied with the hand function. Conclusions Successful replantation for a radiocarpal joint amputation is associated with major restriction of motion, decreased strength, and moderate disability on functional outcome assessments. Type of study/level of evidence Therapeutic IV.
| Original language | English |
|---|---|
| Pages (from-to) | 266-270 |
| Number of pages | 5 |
| Journal | Journal of Hand Surgery |
| Volume | 40 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 1 2015 |
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Keywords
- amputation wrist
- outcomes
- radiocarpal
- Replant
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
Cite this
Functional outcomes of replantation following radiocarpal amputation. / Patel, Amar Arun; Blount, Andrew L.; Owens, Patrick; Askari, Morad.
In: Journal of Hand Surgery, Vol. 40, No. 2, 01.01.2015, p. 266-270.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Functional outcomes of replantation following radiocarpal amputation
AU - Patel, Amar Arun
AU - Blount, Andrew L.
AU - Owens, Patrick
AU - Askari, Morad
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Purpose To assess the long-term functional and clinical outcomes of patients who have undergone replantation after radiocarpal amputation. Methods We performed a retrospective review of radiocarpal joint amputations at a level 1 trauma center over a 13-year period. Medical records of patients treated with replantation were queried for injury data, operative reports, complications, and clinical progress. Patients who met inclusion criteria were contacted for long-term follow-up. We measured total active motion of each digit, strength (grip and pinch), and 2-point discrimination. Functional outcomes were assessed with Disabilities of Arm, Shoulder, and Hand score, Mayo Wrist Score, Patient-Rated Wrist Evaluation, and Michigan Hand Questionnaire. Descriptive statistics were calculated, including frequencies for categorical variables and means and ranges for continuous variables. Results Six patients met the inclusion criteria. The mean age was 36 years (range, 26-50 y). Five patients were available at a mean follow-up of 3.9 years (range, 1.0-6.9 y). Compared with the contralateral uninjured extremity, total active motion of the hand was 38% (range, 26% to 59%) and grip strength was 9% (range, 0% to 18%). Neither tip nor key pinch was present. Mean 2-point discrimination was 10.6 mm (range, 8-12 mm). All mean outcome scores indicated moderate disability, including Disabilities of Arm, Shoulder, and Hand (76; range, 45-82), Mayo Wrist Score (23; range, 5-50), Patient-Rated Wrist Evaluation (86; range, 56-98), and Michigan Hand Questionnaire (27; range, 15-55). Two patients were able to return to work and 3 were permanently disabled. All patients were satisfied with the hand function. Conclusions Successful replantation for a radiocarpal joint amputation is associated with major restriction of motion, decreased strength, and moderate disability on functional outcome assessments. Type of study/level of evidence Therapeutic IV.
AB - Purpose To assess the long-term functional and clinical outcomes of patients who have undergone replantation after radiocarpal amputation. Methods We performed a retrospective review of radiocarpal joint amputations at a level 1 trauma center over a 13-year period. Medical records of patients treated with replantation were queried for injury data, operative reports, complications, and clinical progress. Patients who met inclusion criteria were contacted for long-term follow-up. We measured total active motion of each digit, strength (grip and pinch), and 2-point discrimination. Functional outcomes were assessed with Disabilities of Arm, Shoulder, and Hand score, Mayo Wrist Score, Patient-Rated Wrist Evaluation, and Michigan Hand Questionnaire. Descriptive statistics were calculated, including frequencies for categorical variables and means and ranges for continuous variables. Results Six patients met the inclusion criteria. The mean age was 36 years (range, 26-50 y). Five patients were available at a mean follow-up of 3.9 years (range, 1.0-6.9 y). Compared with the contralateral uninjured extremity, total active motion of the hand was 38% (range, 26% to 59%) and grip strength was 9% (range, 0% to 18%). Neither tip nor key pinch was present. Mean 2-point discrimination was 10.6 mm (range, 8-12 mm). All mean outcome scores indicated moderate disability, including Disabilities of Arm, Shoulder, and Hand (76; range, 45-82), Mayo Wrist Score (23; range, 5-50), Patient-Rated Wrist Evaluation (86; range, 56-98), and Michigan Hand Questionnaire (27; range, 15-55). Two patients were able to return to work and 3 were permanently disabled. All patients were satisfied with the hand function. Conclusions Successful replantation for a radiocarpal joint amputation is associated with major restriction of motion, decreased strength, and moderate disability on functional outcome assessments. Type of study/level of evidence Therapeutic IV.
KW - amputation wrist
KW - outcomes
KW - radiocarpal
KW - Replant
UR - http://www.scopus.com/inward/record.url?scp=84921549023&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84921549023&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2014.10.017
DO - 10.1016/j.jhsa.2014.10.017
M3 - Article
C2 - 25499843
AN - SCOPUS:84921549023
VL - 40
SP - 266
EP - 270
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
SN - 0363-5023
IS - 2
ER -