Replantation of Amputated Digits in Elderly Patients.

Chung, Soon Il; Kim, Jin Soo; Lee, Dong Chul; Ki, Sae Hwi; Roh, Si Young; Yang, Jae Won

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(5):644-649.
Published online September 1, 2010.

Replantation of Amputated Digits in Elderly Patients.

Soon Il Chung, Jin Soo Kim, Dong Chul Lee, Sae Hwi Ki, Si Young Roh, Jae Won Yang

Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital, Gyeonggi-do, Korea. pskm@paran.com

Abstract

PURPOSE
As the mean life expectancy of people has been prolonged, and the elderly people who participate in the production activities has been increasing, it is expected that the demand on the replantation of amputated digits in elderly patients would increase. But, there are few studies about the replantation of amputated digits in elderly patients. Therefore, we report treatment outcomes of replantation of amputated digits in elderly patients. METHODS: From 1998 to 2008, the replantation was performed in 51 completely amputated digits of 33 patients aged 60 years or older. We performed the replantation in the usual manner. Under the brachial plexus block, the surgical procedures carried out in the following sequence: internal fixation using Kirschner wire, tenorrhaphy, arteriorrhaphy, neurorrhaphy and venorrhaphy. If the arterial ends could not be approximated without tension, a vein graft was performed.
RESULTS
Of a total of 51 digits, 46 digits (90%) survived. 13 patients (40%) had underlying medical problem preoperatively. But, in all the patients, there were no postoperative medical complications. As the postoperative surgical complications, excluding five cases of the total necrosis of digit, there were three cases of venous congestion, two cases of arterial insufficiency, seven cases of infection and 16 cases of partial necrosis.
CONCLUSION
Age alone does not affect the survival of replanted digits. Type of injury is the most important factor that affects the survival of replanted digits.

Keywords: Elderly; Traumatic amputation; Replantation