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CC-BY-NC-ND 4.0 · J Reconstr Microsurg Open 2017; 02(01): e78-e82
DOI: 10.1055/s-0037-1604157
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Patient Satisfaction and Hand Performance Following Fingertip Reconstruction: A Retrospective Cohort Study

Daisuke Kaji
1   Limb Trauma Center, Nara City Hospital, Nara, Japan
,
Shohei Omokawa
2   Department of Hand Surgery, Nara Medical University, Nara, Japan
,
Akito Nakanishi
3   Department of Orthopedic Surgery, Takita Hospital, Nara, Japan
,
Kenji Kawamura
4   Department of Orthopedic Surgery, Nara Medical University, Nara, Japan
,
Takamasa Shimizu
4   Department of Orthopedic Surgery, Nara Medical University, Nara, Japan
,
Yasuhito Tanaka
4   Department of Orthopedic Surgery, Nara Medical University, Nara, Japan
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Publikationsverlauf

31. Dezember 2016

25. Mai 2017

Publikationsdatum:
06. Juli 2017 (online)

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Abstract

Introduction Hand performance tests that evaluate hand dexterity and use in daily living have been frequently used to evaluate outcomes in patients with various hand disorders but not in patients with fingertip injuries. The present study aimed to evaluate patient satisfaction and hand performance following digital artery flap reconstruction for fingertip injury and identify factors associated with these outcomes.

Methods This retrospective cohort study included 25 patients with amputation injuries at our institution between 2003 and 2013. Patients with amputations at the Tamai 1 or 2 zone of their index (14 patients) or middle finger (11 patients) who underwent digital artery flap surgery and were followed up for > 1 year were included. Follow-up evaluations were conducted at an average of 44 months postoperatively (range, 12–105 months). The primary outcomes were patient satisfaction and hand performance determined by a 4-grade Likert scale and the Purdue Pegboard test, respectively. Secondary outcomes were recovery of sensitivity measured by Semmes–Weinstein monofilaments, total active finger motion (TAM), and tip pinch strength.

Results There were no postoperative complications. Patient satisfaction was rated as fair, good, and excellent, in 1, 15, and 9 patients, respectively. The average hand performance test scores were significantly lower in the affected finger than the adjacent finger (22 vs. 30, respectively; p < 0.05). The mean ± standard deviation (SD) sensitivity test score was 3.5 ± 1.6 (range, 2.4–4.0). The average percentage TAM and tip pinch strength compared with the contralateral hand were 82 (range, 45–100%) and 82% (range, 60–112%), respectively. The hand performance score significantly correlated with the recovery of sensitivity and age (r = – 0.42 and 0.43, respectively; both p < 0.05). Patient satisfaction was significantly correlated with TAM (r = 0.42, p < 0.05) and tended to correlate with the recovery of sensitivity (r = – 0.395, p = 0.051).

Conclusion Although reconstructed fingers had a lower performance score than the adjacent fingers, patient satisfaction with flap surgery was relatively high. Recovery of finger sensitivity contributed to patient satisfaction and enhanced dexterity of motor skill activities following fingertip reconstruction.

Keywords

performance - fingertip - reconstruction