Objectives: Replantation of a single finger amputated at the flexor zone 2 level keeps contradicting because the replanted finger may get in the way of other digits due to stiffness. On the other hand, some studies concluded that as the replantation results do not differ from stump closure, one should not immediately head towards stump closure. Therefore, we aimed to present our functional results of this level of replantation.
Methods: Twenty-one patients with replantation for single finger flexor zone 2 total amputation were enrolled in the study. Kirschner wires were used to fix the bone. Only flexor digitorum profundus (FDP) tendon was repaired. Two veins per digital artery were anastomosed. Early motion was allowed from the third postoperative week. The functional results were assessed by Quick-DASH and modified Mayo scores, total active range of motion (TAM), and presence of cold intolerance.
Results: The mean follow-up period was 33.9 (range 24-79) months. The mean Quick-DASH score was 18.1±8.6 (range 2.3-38.6). According to the modified Mayo score, three patients had excellent, nine had good, seven had fair, and two had poor results. TAM was found to be excellent in three, good in eleven, fair in five, and poor in two patients.
Conclusion: We recommend bone fixation preserving the joints, only FDP tendon repair, vein anastomoses as many as possible, and early motion to achieve successful results in single finger amputations replanted at the flexor zone 2 level.
Key words: amputation; flexor zone 2 level; replantation.
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