Long-Term Outcomes of Successful Fingertip Replantation: A Follow-Up of at Least 10 Years

Background: The purpose of this study was to evaluate the long-term outcome of successful fingertip replantations with more than 10 years of follow-up after surgery. Methods: A total of 34 successfully replanted digits in 31 patients with a mean period to follow-up of 16.5 years were included in this study. The main outcome measures were time to return to work, pain, cold intolerance, sensory recovery, nail deformity, grip strength, range of motion of the thumb interphalangeal or finger distal interphalangeal joint, fingertip atrophy, nonunion, bone shortening, use in activities of daily living, and patient satisfaction. Results: None of the patients reported chronic pain. No cold intolerance was experienced in 32 digits. Semmes-Weinstein monofilament testing showed recovery of protective sensation in 27 digits. The moving two-point discrimination test showed excellent or good recovery in 91 percent of the patients. Sensory recovery was satisfactory, and there was no significant difference regardless of nerve repair or injury type. Moderate to severe nail deformity was found in six digits. Fingertip atrophy was evaluated by comparing the volume of the replanted fingertip with the contralateral digit. The volume was 82 +/- 17 percent of the contralateral normal side. There was no significant difference in the volume comparing the level of amputation, injury type, or incidence of postoperative vascular complication. Ninety-seven percent of the patients were satisfied with the results. Conclusion: Long-term outcome of fingertip replantation more than 10 years after surgery was found to be favorable.