30 巻 (2017) 1 号 p. 8-14
The purpose of this study was to report the clinical results and problems of replantation and reconstruction surgeries for polydigit amputation. Sixty polydigit amputations of 21 patients who had more than one digit proximal to Tamai's zone III amputation were retrospectively reviewed. The complete survival rate of replantation was 87% ( 45 of 52 digits ). The %TAM of digits of zone IV was significantly lower than that of other zones ( mean 28%, p<0.01 ). At the final follow-up for patients who underwent second toe transfer for finger reconstruction, the %TAM and grip strength of the finger proximal to the proximal interphalangeal ( PIP ) joint was significantly lower than those of the finger distal to the PIP joint ( %TAM ; 72% : 28%, p<0.05, grip strength ; 70% : 21% of normal side, p< 0.05 ). The success rate of polydigit replantation was comparable with that of the single finger replantation; however, clinical outcomes were poor, especially in zone IV. In the second toe transfer for finger defects, better clinical results were achieved for the finger distal to the PIP joint than for the finger proximal to the PIP joint.