Replantation of Amputated Digits in Elderly Patients

고령 환자의 절단된 수지의 재접합술

  • Chung, Soon-Il (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Kim, Jin-Soo (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Lee, Dong-Chul (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Ki, Sae-Hwi (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Roh, Si-Young (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital) ;
  • Yang, Jae-Won (Department of Plastic and Reconstructive Surgery, Kwangmyung Sung-Ae General Hospital)
  • 정순일 (광명성애병원 성형외과) ;
  • 김진수 (광명성애병원 성형외과) ;
  • 이동철 (광명성애병원 성형외과) ;
  • 기세휘 (광명성애병원 성형외과) ;
  • 노시영 (광명성애병원 성형외과) ;
  • 양재원 (광명성애병원 성형외과)
  • Received : 2010.04.26
  • Accepted : 2010.07.19
  • Published : 2010.09.10

Abstract

Purpose: As the mean life expectancy of people has been prolonged, and the elderly people who participate in the production activities has been increasing, it is expected that the demand on the replantation of amputated digits in elderly patients would increase. But, there are few studies about the replantation of amputated digits in elderly patients. Therefore, we report treatment outcomes of replantation of amputated digits in elderly patients. Methods: From 1998 to 2008, the replantation was performed in 51 completely amputated digits of 33 patients aged 60 years or older. We performed the replantation in the usual manner. Under the brachial plexus block, the surgical procedures carried out in the following sequence: internal fixation using Kirschner wire, tenorrhaphy, arteriorrhaphy, neurorrhaphy and venorrhaphy. If the arterial ends could not be approximated without tension, a vein graft was performed. Results: Of a total of 51 digits, 46 digits (90%) survived. 13 patients (40%) had underlying medical problem preoperatively. But, in all the patients, there were no postoperative medical complications. As the postoperative surgical complications, excluding five cases of the total necrosis of digit, there were three cases of venous congestion, two cases of arterial insufficiency, seven cases of infection and 16 cases of partial necrosis. Conclusion: Age alone does not affect the survival of replanted digits. Type of injury is the most important factor that affects the survival of replanted digits.

Keywords

References

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