The Declining Number of Finger Replantations in Germany.

Introduction: Data from the United States have shown that finger replantation numbers have declined significantly in recent years. It is unclear whether this is due to a decrease in amputation injuries or other reasons.

Materials Methods: Since 2005, all German hospitals have been required to produce structured quality reports. Based on these reports, we analyzed finger and hand replantation development and the incidence of amputation injuries between 2006 and 2018.

Results: Replantations decreased by 30%, whereas amputation injuries increased slightly. In 2018, only 17 centers carried out more than 10 replantations. Most hospitals had replanted less than 4 times a year. The majority of residents participated in fewer than 1 replantation per year. Most specialists performed fewer than 1 replantation per year. The reasons for the decline in replantation remain speculative.

Conclusions: However, a reduction in amputation injuries was not observed. A change in medical indications, technical skills, and economic motivations needs to be considered. A further loss of specialized technical skills and experience with replantations might be a future consequence of this trend.