A systematic review of outcomes of revision amputation treatment for fingertip amputations
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A systematic review of outcomes of revision amputation treatment for fingertip amputations Keming Wang & Erika Davis Sears & Melissa J. Shauver & Kevin C. Chung
Published online: 12 January 2013 # American Association for Hand Surgery 2013
Abstract Purpose The purpose of this study was to conduct a systematic review of outcomes of fingertip revision amputation for fingertip amputation injuries in the Englishlanguage literature to provide best evidence of functional outcomes. Methods A MEDLINE literature search was performed to identify studies that met the following criteria: (1) reported primary data; (2) included at least five cases of primary revision amputation treatment following digit amputation injury; (3) reported finger or thumb amputation at or distal to the distal interphalangeal (DIP) joint or interphalangeal (IP) joint, respectively; (4) presented at least one of the following outcomes: static two-point discrimination (2PD), cold intolerance, arc of motion (AOM) of metacarpophalangeal (MCP) joints, proximal interphalangeal joints (PIP), DIP joints, or return-to-work time. K. Wang 17th Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China E. D. Sears Section of Plastic Surgery, The University of Michigan Health System, Ann Arbor, MI, USA M. J. Shauver Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, MI, USA K. C. Chung (*) Section of Plastic Surgery, University of Michigan Medical School, 2130 Taubman Center, SPC 5340, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5340, USA e-mail: [email protected] K. C. Chung Faculty Affairs, The University of Michigan Medical School, 2130 Taubman Center, SPC 5340, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-5340, USA
Results Thirty-eight studies met the inclusion criteria. Twenty-seven studies reported 2PD, 20 studies reported cold intolerance, eight studies reported AOM, and 18 studies reported return-to-work time after revision amputation of fingertip injuries. The mean 2PD was 5.6 mm. On average, 24 % of patients experienced cold intolerance. AOM at the PIP joint was reported in four studies and averaged 94°. DIP joint AOM was presented in four studies and averaged 66°. Thumb MCP and IP joint AOM was presented in three and four studies, respectively. Mean thumb MCP joint AOM was 54° and that of the IP joint was 71°. The mean returnto-work time was 47 days. Conclusions On average, fingertip revision amputation can achieve almost normal sensibility and satisfactory motion and patients can expect to return to work on average approximately 7 weeks after surgery. Keywords Fingertip amputation . Hand surgery outcomes . Systematic review . Treatment Fingertip amputation, involving the distal interphalangeal joint (DIP) for fingers and the interphalangeal (IP) joint for the thumb [23], is the most common amputation injury treated by hand surgeons. Sixty-three percent of patients do not underg
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