A Systematic Review of Outcomes of Revision Amputation Treatment for Fingertip Amputations

• Published in: HAND Vol. 8; no. 2; pp. 139 - 145
• Main Authors: Wang, Keming, Sears, Erika Davis, Shauver, Melissa J., Chung, Kevin C.
• Format: Book Review Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.06.2013; Springer-Verlag
• Subjects: Medicine; Medicine & Public Health; Orthopedics; Plastic Surgery; Review Articles of topics; Review of topics; Surgery; Surgical Orthopedics; Systematic review; Fingertip amputation; Treatment; Hand surgery outcomes
• ISSN: 1558-9447; 1558-9455
• DOI: 10.1007/s11552-012-9487-0

Purpose The purpose of this study was to conduct a systematic review of outcomes of fingertip revision amputation for fingertip amputation injuries in the English-language literature to provide best evidence of functional outcomes. Method 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. 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 return-to-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.