REPLANTATION-REVASCULARIZATION AND PRIMARY AMPUTATION IN MAJOR HAND INJURIES - RESOURCES SPENT ON TREATMENT AND THE INDIRECT COSTS OF SICK LEAVE IN SWEDEN

Thirty consecutive patients with amputation or devascularizing injurie s of the thumb or two or more fingers proximal to the PIP joint were r eviewed. Replantation or revascularization had been done in 27 patient s, in 24 successfully. Three patients had primary amputation. The dist ribution of calculable costs was dominated by those for sick leave (49 %), operation (26%) and ward costs (20%). Out-patient care, physiother apy and travel together constituted only 6%. The cost of a successful replantation was equal to 1.6 times the mean annual salary of these pa tients and that of primary amputation about half as much. Mobility, po wer and performance of a standardized grip test were better for the su ccessfully replanted or revascularized patients. Subjective evaluation of 23 parameters of function, cosmesis and quality of life did not di sclose any differences. All patients except three had returned to thei r original work within 2 years.