Complete digital amputations undergoing replantation surgery: a 10-year retrospective study.

Background: As a result of growing expertise and skill, replantation surgery has evolved to more than the technical reattachment of an amputated part.

Methods: A retrospective study of complete digital amputations undergoing replantation surgery was conducted for the purpose of assessing trends in these complex cases. All incomplete and partial amputations were excluded.

Results: A total of 171 patients who had replantation surgery between January 1, 1994 and December 31, 2003 for 278 completely amputated digits were reviewed. Of the 171 patients, 91 (53 %) had work-related injuries. The main mechanism of injury was saw injury (95 patients) for both occupational- and non-occupational-related injuries. The proximal phalanx was the most common level of amputation and the thumb was most frequently involved. The injuries happened more commonly in the summer months. Microvascular failure occurred in 29 % of the replanted digits and was most commonly associated with avulsion-type injuries.

Conclusions: Complete amputations represent a more complex injury than incomplete amputations, with a higher failure rate.