LATE RESULTS AFTER MICROVASCULAR RECONSTRUCTION OF SEVERE CRUSH AND AVULSION INJURIES OF THE UPPER EXTREMITY

From 1978 to 1985, a total of 64 patients underwent successful hand an d digit replantation/revascularisation for salvage after crush and avu lsion trauma to their upper extremities. Forty-seven of them (39 males and 8 females) were followed between 10 and 17 years (mean: 12.6 year s). The average patient age was 33.2 years. In 39 patients, replantati ons were performed: 37 digits (including seven thumbs), two hands, and three midhands. Eight patients underwent revascularizations in cases of subtotal amputations: two in the midhand, three at the wrist, and t hree at the lower arm. Concomitant injury to the hand or forearm was a feature of all cases. In 45 percent of the study population, secondar y reconstructions were necessary. Outcomes were evaluated using Chen's classification (1981) and showed that 19 percent of the patients were classified grade I, 49 percent grade II, 28 percent grade III, and 4 percent grade IV. Results demonstrated a greater patient age in the gr ade III group, and relatively more secondary operations in the grade I V patients.