Outcome of Thumb Replantation following Traumatic Amputation: A Review of Three Cases

Abstract

This paper presents the functional outcome in three patients who sustained a traumatic level-three thumb amputation and replantation during a six-week period and evaluates their functional outcome. It also discusses the current literature on this subject and suitable methods for assessing and reporting the outcomes of these injuries. Assessment was carried out at a mean of 40 weeks post operation (range 36-47) by the same independent therapist. Mean active interphalangeal joint flexion was 47° (range 30-75°) and metacarpophalangeal joint 42° (range 35-50°). Grip strength was a mean of 89 lbs (range 79-101 lbs) and pinch grip was a mean of 12.5 lbs (range 9-18 lbs). On sensory assessment two of the participants had a good return of sensibility with 5-7mm of two-point discrimination and at least diminished protective sensation. Overall satisfaction, sensibility and functional use of the thumb did not appear to be related to age but rather due to the demands placed on their replanted thumb for occupation and hand dominance.