2022 Volume 35 Issue 3 Pages 122-129
In this study, 41 fingers with complete replantation were divided into two groups: a PIP joint preservation group (JP group) (n = 23 fingers) , and a PIP joint arthrodesis group (JA group) (n = 18 fingers) . We investigated the injury patterns and active joint range-of-motion of the replanted fingers and compared the two groups. In the JP group (compared to the JA group) , total active range-of-motion (TAM) was 138.9° (80.4°) , MP joint AM was 80.4° (74.4°) , and PIP joint + DIP joint AM was 58.5° (5.0°) . There were significant differences in TAM, and PIP joint + DIP joint AM between the two groups. Nine of the 23 fingers in the JP group underwent tenolysis to improve postoperative TAM. The effect of tenolysis was not constant, and the average improvement in TAM was 55.0° (20°-150°) . The two patients in whom TAM significantly improved were those in which joint contracture before tenolysis was not observed and those in which only flexor tenolysis was performed. The range-of-motion of the fingers that underwent Tamai zone 4 replantation was still poor. However, to minimize joint contracture, two-stage flexor tenolysis is recommended, which may greatly improve the range-of-motion of fingers that underwent Tamai zone 4 replantation.
