Abstract

  Avulsion amputation injury of the digits of the hand is an uncommon and grave lesion when appeared in the emergency department. Replantation of an amputated digit constitutes a challenge for hand surgeon. This trauma presents a particularly difficult problem to manage because of simultaneous damage of the skin, vessels, nerve and tendons while different surgical techniques have been proposed in international bibliography for the reconstruction of this lesion with a variety of functional results. We report a case after a traffic accident presented with a delay of four hours with an amputation avulsion injury of left thumb in distal interphalangeal joint with avulsion of flexor pollicis longus from musculotendinous junction and concomitant tear of extensor pollicis longus. The aim of this study is to analyze the current concepts of therapeutic management of this type of lesions.

Keywords: Amputation; Hand; Avulsion; Thumb; Flexor Pollicis Longus Tendon

References

1. De Putter CE., et al. “EFEconomic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study”. Journal of Bone and Joint Surgery American 9 (2012): e56.
2. De Jong JP., et al. “The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study”. Clinics in Orthopedic Surgery 2 (2014):196-202.
3. Kamarul T., et al. “Replantation and revascularization of amputated upper limb appendages outcome and predicting the factors influencing the success rates of these procedures in a tertiary hospital: An 8-year retrospective, cross-sectional study”. Journal of Orthopaedic Surgery.1 (2017): 1-9.
4. Medling BD., et al. “Replantation outcomes”. Clinics in Plastic Surgery 34 (2007): 177-185.
5. Urbaniak JR., et al. “Microvascular management of ring avulsion injuries”. The Journal of Hand Surgery American 6 (1981): 25-30.
6. Collins J., et al. “Management of digital tendon avulsion at the musculotendinous junction of the forearm: a systematic review”. Hand2 (2012): 134-142.
7. Boyes HJ., et al. “Flexor-tendon ruptures in the forearm and hand”. The Journal of Bone and Joint Surgery4 (1960): 637-646.
8. Stevanovic MV., et al. “Avulsion injuries of the thumb”. Plastic and Reconstructive Surgery6 (1991): 1099-1104.
9. Sharma S., et al. “Thumb replantation: A retrospective review of 103 cases”. Annals of Plastic Surgery 55 (2005): 352‑356.
10. Dadaci M., et al. “Assessment of survival rates compared according to Tammai AND Yamano classifications in fingertip replantation”. The Indian Journal of Orthopaedics 4 (2016): 384-389.
11. Adani R., et al. “Results of remplantation of 33 ring finger avulsion amputation”. Journal of Hand Surgery 5 (2013): 947-956.
12. Sears ED and Chung KC. “Replantation of finger avulsion injuries: A systematic review of the survival and functional outcomes”. The Journal of Hand Surgery American 4 (2011): 686-694.
13. Saremi H and Karbalaeikhani A. “Tendon transfer in hand trauma: a case report”. Trauma Monthly 4 (2013): 401-403.
14. Dec W. “A meta-analysis of success rates for digit replantation”. Techniques in Hand and Upper Extremity Surgery 10 (2006): 124-129.
15. Sebastin SJ and Chung KC. “A systematic review of the outcomes of replantation of distal digital amputation”. Plastic and Reconstructive Surgery 128 (2011): 723-737.
16. Chim H., et al. “Challenges in replantation of complex amputations”. Seminars in Plastic Surgery 27 (2013): 182-189.
17. Battiston B., et al. “Actualities in big segments replantation surgery”. Journal of Plastic, Reconstructive and Aesthetic Surgery 60 (2007): 849-855.
18. Waikakul S., et al. “Results of 1018 digital replantations in 552 patients”. Injury 31 (2000): 33-40.
19. Goldner RDUJ. “Replantation. In: Wolfe SWHR, Pederson WC, and Kozin SH (editions) Green’s Operative Hand Surgery, 6th edition. Philadelphia: Elsevier Health Sciences (2010): 1585-1601.
20. Hamilton RB., et al. “Survival factors in replantation and revascularization of the amputated thumb - 10 years experience”. Scandinavian Journal of Plastic and Reconstructive Surgery 18 (1984): 163-173.
21. Lindenhovius AL., et al. “Correspondence between perceived disability and objective physical impairment after elbow trauma”. Journal of Bone and Joint Surgery American 90 (2008): 2090-2097.
22. Sebastin SJ and Chung KC. “A systematic review of the outcomes of replantation of distal digital amputation”. Plastic and Reconstructive Surgery 128 (2011): 723-737.

Citation

Citation: Kastanis G., et al. “Traumatic Musculotendinous Avulsion of the Flexor Pollicis Longus Tendon: Current Concepts in Strategic Management".Acta Scientific Orthopaedics 3.10 (2020): 05-08.

Copyright

Copyright: © 2020 Kastanis G., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.