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DOI: 10.5999/aps.2015.42.5.614
Short-Term Strength Deficit Following Zone 1 Replantations
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.
The authors thank Dr. Aram Harijan for his insight and assistance in the preparation of this manuscript.
Publication History
Received: 17 March 2015
Accepted: 01 June 2015
Article published online:
05 May 2022
© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
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References
- 1 Hume MC, Gellman H, McKellop H. et al. Functional range of motion of the joints of the hand. J Hand Surg Am 1990; 15: 240-243
- 2 Ross DC, Manktelow RT, Wells MT. et al. Tendon function after replantation: prognostic factors and strategies to enhance total active motion. Ann Plast Surg 2003; 51: 141-146
- 3 Gunther CM, Burger A, Rickert M. et al. Grip strength in healthy caucasian adults: reference values. J Hand Surg Am 2008; 33: 558-565
- 4 Shim JH, Roh SY, Kim JS. et al. Normative measurements of grip and pinch strengths of 21st century Korean population. Arch Plast Surg 2013; 40: 52-56
- 5 Walaszek I, Zyluk A. Long term follow-up after finger replantation. J Hand Surg Eur Vol 2008; 33: 59-64
- 6 Hasuo T, Nishi G, Tsuchiya D. et al. Fingertip replantations: importance of venous anastomosis and the clinical results. Hand Surg 2009; 14: 1-6
- 7 Tamai S. Twenty years' experience of limb replantation: review of 293 upper extremity replants. J Hand Surg Am 1982; 7: 549-556
- 8 Mathiowetz V, Kashman N, Volland G. et al. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil 1985; 66: 69-74
- 9 Haidar SG, Kumar D, Bassi RS. et al. Average versus maximum grip strength: which is more consistent?. J Hand Surg Br 2004; 29: 82-84
- 10 Crosby CA, Wehbe MA, Mawr B. Hand strength: normative values. J Hand Surg Am 1994; 19: 665-670
- 11 Waikakul S, Sakkarnkosol S, Vanadurongwan V. et al. Results of 1018 digital replantations in 552 patients. Injury 2000; 31: 33-40
- 12 Hattori Y, Doi K, Ikeda K. et al. Significance of venous anastomosis in fingertip replantation. Plast Reconstr Surg 2003; 111: 1151-1158
- 13 Chen HC, Tang YB. Replantation of the thumb, especially avulsion. Hand Clin 2001; 17: 433-445
- 14 Holmberg J, Lindgren B, Jutemark R. Replantation-revascularization and primary amputation in major hand injuries: resources spent on treatment and the indirect costs of sick leave in Sweden. J Hand Surg Br 1996; 21: 576-580
- 15 Ohtsuki T. Inhibition of individual fingers during grip strength exertion. Ergonomics 1981; 24: 21-36
- 16 MacDermid JC, Lee A, Richards RS. et al. Individual finger strength: are the ulnar digits "powerful"?. J Hand Ther 2004; 17: 364-367
- 17 Norman K, Stobaus N, Gonzalez MC. et al. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr 2011; 30: 135-142