TRANSPOSITIONAL MICROSURGERY IN MULTIPLE DIGITAL AMPUTATIONS

In 34 of the 62 patients treated for complete multiple digital amputat ions, the severed part was not replanted in its anatomical position, b ut in the place of the most useful stump. This procedure is defined as transpositional digital microsurgery and refers to the transposition and replantation of any digit to another stump which plays a more sign ificant role in the function of the hand. Twenty-eight patients had tr ansposition of a digit, while six patients underwent thumb transpositi on. All except six of the transposed digits survived, while all of the thumbs survived the surgical procedure. The cosmetic appearance of th e hand with a transposed digit or thumb was acceptable to the patients . Two-point discrimination was assessed to be 10-14 mm for the transpo sed digits, and the functional ability of the transplanted digit was c omparable to digits which were replanted in their anatomical position. In conclusion, transpositional digital microsurgery remains a useful alternative for the treatment of multiple digit amputations, particula rly in patients with severely damaged non-replantable amputated parts. (C) 1994 Wiley-Liss, Inc.