Functional recovery of distal phalanx replantation

Objective To report the long term functional results of distal phalanx replantation. Methods 42 successfully replanted fingers in 38 patients were available and followed-up for an average of 27 months(10 -54 months). Results The average active range of motion in the interphalangeal joint of thumb(IP) and in the distal interphalangeal joint of fingers(DIP), excluding those arthrodesed, were 49 degrees and 52 degrees. Sensory assessment showed a mean of 7.2 mm two-point discrimination(2PD). According to Tamai's scoring criteria, the functional results of 42 fingers were 25 excellent and 17 were good. Conclusion Accurate primary nerve repair is essential, patients in whom only one nerve repaired or without nerve repaired have a relative bad sensory recovery. Arthrodesis should be attempted when the amputation occured through the distal interphalangeal joint. Postreplantation atrophy might be due to inadequate perfusion or disuse.