Abstract
Bone fixation at digital replantation often has a critical impact on the entire rehabilitation program, months or even years after the initial repair. The incidence of bony union problems following replantation can reach as high as 30 - 40 %. We examined the factors affecting delayed union and nonunion after digital replantation in 34 patients with 42 replanted digits in Tamai zones I to V. The radiographic information was reviewed retrospectively. Five females and 29 males averaging 48.6 years of age were followed for an average of 35 weeks. Thirty-two digits went on to bone union at an average of 15 weeks after replantation. Delayed union or nonunion occurred in ten digits ( 24 % ). Of the variables examined (age, gender, zone and type of amputation, fixation technique, and gap at the fixation site), univariate risk factors for delayed union and nonunion were female gender and amputations distal to the distal interphalangeal joint. However, no risk factors were significant on multivariate analysis. Our data suggest that a large series of females with replanted digits is needed to determine the role of gender in delayed union and nonunion following replantation because of the different outcomes in the univariate and multivariate analyses.
