Postoperative Evaluation of Patient Satisfaction and Tingling Sensation after Replantation Surgery without Nerve Repair for Complete Digital Amputation

Abstract

Background When performing replantation surgery for complete fingertip amputation, we do not perform digital nerve repair. We hypothesized that this method would not decrease patient satisfaction. Methods Between July 2011 and August 2013, we performed replantation surgery for 21 complete digital amputations in 18 patients. Digital nerves were not repaired for fingertip amputations. For proximal to distal interphalangeal joint amputations (proximal amputation), however, we repaired as many digital nerves as possible. We followed 17 replanted fingers in 14 patients (fingertip, 9 fingers in 9 patients; proximal, 8 fingers in 5 patients) for > 1 year, performing retrospective evaluation of subjective outcomes via telephone surveys. Patient satisfaction and fingertip tactile sensation scores (FTSS) were rated on scales of 0 to 10; unpleasant sensations (paresthesia or dysesthesia) were also surveyed. Results Mean patient satisfaction was significantly greater in the fingertip-amputation group than in the proximal-amputation group (9.4 and 7.6, respectively), although mean FTSS did not show significant difference (6.0 and 3.6, respectively). Patients with proximal amputations had dysesthesia in three fingers, paresthesia in one finger, and no numbness in four fingers, whereas patients with fingertip amputations had dysesthesia in three fingers, paresthesia in four fingers, and no numbness in two fingers. Patients with fingertip amputation had significantly more unpleasant sensation than those with proximal amputations. Conclusion Although fingertip replantation without digital nerve repair causes postoperative tingling, it results in good patient satisfaction.