J Reconstr Microsurg 2010; 26(5): 347-354
DOI: 10.1055/s-0030-1249320
© Thieme Medical Publishers

Do We Need to Repair the Nerves When Replanting Distal Finger Amputations?

Clara Wong1 , Pak Cheong Ho1 , Wing Lim Tse1 , Sally Cheng1 , Derwin King Chung Chan1 , 2 , Leung Kim Hung1 , 2
  • 1Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Shatin, N.T., Hong Kong
  • 2The Hong Kong Jockey Club Sports Medicine & Health Sciences Centre, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
Further Information

Publication History

Publication Date:
02 March 2010 (online)

ABSTRACT

Distal replantation is an excellent model to study the results of nerve repair. We aim to demonstrate differences in aesthetic, sensory, and functional outcomes in fingertip replantation, with and without nerve repair. We recruited 28 fingers in 28 patients, who had successful distal replantation in 5 years. Half of the fingers had nerves repaired. Mean follow-up was 39 months. Symptoms of pain, numbness, cold intolerance, scar hypersensitivity, pulp atrophy, and weakness were reported. Nail width, pulp length, 2-point discrimination, Semmes–Weinstein test, and power were evaluated. We used chi-square tests of independence to examine association between nerve repair and symptoms, and independent t tests and Mann–Whitney U tests to analyze difference between replantation with and without nerve repair according to objective results. Chi-square tests reviewed no significant association between nerve repair and symptoms. Mann–Whitney U tests showed no significant difference between the groups, with and without nerve repair. All fingers showed mean 2-point discrimination of 5.6 mm, and Semmes–Weinstein test results of green in 3 fingers and blue in 17. There was no significant difference in overall outcomes in repairing nerve or not in distal finger replantation. Both groups had satisfactory outcomes. Possibly, spontaneous neurotization is present, and nerve repair is not necessary, which may help to shorten the operation time and decrease extensiveness of surgeries.

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Clara WongM.D. 

Department of Orthopaedics and Traumatology, Prince of Wales Hospital

Shatin, N.T., Hong Kong 852

Email: clara.wongclara@gmail.com

Email: clarawong@ort.cuhk.edu.hk