MAJOR REPLANTATION VERSUS REVISION AMPUTATION AND PROSTHETIC FITTING IN THE UPPER EXTREMITY - A LATE FUNCTIONAL OUTCOMES STUDY

The functional outcomes of amputated arms:hat were either replanted or had a prosthesis were compared. In addition, factors that influenced the functional outcome of replants were evaluated. The Carroll test wa s used to evaluate functional capacity of 22 successful upper extremit y replantations at or proximal to the wrist as well as 22 amputees (at similar levels) fitted with a variety of prosthetic devices. The outc ome was excellent or good in 8 (36%) replanted limbs. This proportion was statistically higher than those grades in the prosthetic group. Wh en the groups were more closely matched (adults with below elbow injur ies), the replantation group had 6 (50%) good or excellent outcomes an d the prosthetic group had none. An analysis of covariance of the repl antations demonstrated a statistical association between a better outc ome in younger patients with more distal injuries. This study indicate s that replantation produces superior functional results compared with amputation and a prosthesis. Copyright (C) 1998 by the American Socie ty for Surgery of the Hand.