Functional outcomes of replantation following radiocarpal amputation

Amar Arun Patel, Andrew L. Blount, Patrick Owens, Morad Askari

Research output: Contribution to journalArticle

5 Citations (Scopus)

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 languageEnglish
Pages (from-to)266-270
Number of pages5
JournalJournal of Hand Surgery
Volume40
Issue number2
DOIs
StatePublished - Jan 1 2015

Fingerprint

Replantation
Amputation
Hand
Wrist
Hand Strength
Arm
Joints
Pinch Strength
Return to Work
Trauma Centers
Medical Records
Extremities
Outcome Assessment (Health Care)
Wounds and Injuries

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 journalArticle

Patel, Amar Arun ; Blount, Andrew L. ; Owens, Patrick ; Askari, Morad. / Functional outcomes of replantation following radiocarpal amputation. In: Journal of Hand Surgery. 2015 ; Vol. 40, No. 2. pp. 266-270.
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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.

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