Short-Term Strength Deficit Following Zone 1 Replantations

• Published in: Archives of plastic surgery Vol. 42; no. 5; pp. 614 - 618
• Main Authors: Roh, Si Young, Shim, Woo Cheol, Lee, Kyung Jin, Lee, Dong Chul, Kim, Jin Soo, Yang, Jae-Won
• Format: Journal Article
• Language: English; Korean
• Published: 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA Thieme Medical Publishers, Inc 01.09.2015; The Korean Society of Plastic and Reconstructive Surgeons; 대한성형외과학회
• Subjects: hand strength; Original; Original Article; pinch strength; range of motion, articular; replantation; 성형외과학; Range of motion, articular; Hand strength; Pinch strength; Replantation
• ISSN: 2234-6163; 2234-6171
• DOI: 10.5999/aps.2015.42.5.614

Background Hand strength deficit following digital replantation is usually attributed to the mechanical deficiency of the replanted digit. Zone 1 replantation, however, should not be associated with any mechanical deficit, as the joint and tendon are intact. We evaluate short-term motor functions in patients who have undergone single-digit zone 1 replantation. Methods A single-institution retrospective review was performed for all patients who underwent zone 1 replantation. Hand and pinch strengths were evaluated using standard dynamometers. Each set of measurements was pooled according to follow-up periods (within 1 month, 1 to 2 months, 2 to 3 months, and after 3 months). The uninjured hand was used as reference for measurements. Results The review identified 53 patients who had undergone zone 1 replantation and presented for follow-up visits. Compared to the uninjured hand, dynamometer measurements revealed significantly less strength for the hand with replanted digit at one month. The relative mean grip, pulp, and key pinch strength were 31%, 46%, and 48% of the uninjured hand. These three strength measurements gradually increased, with relative strength measurements of 59%, 70%, and 78% for 4-month follow up. Conclusions Despite the lack of joint or tendon injury, strength of the injured hand was significantly lower than that of the uninjured hand during the 4 months following replantation. Improved rehabilitation strategies are needed to diminish the short-term negative impact that an isolated zone 1 replantation has on the overall hand strength.