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CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(S 01): S43-S49
DOI: 10.1055/s-0044-1788664
Original Article

A Prospective Comparative Study of Ray Resection versus Amputation through Proximal Phalanx for Nonviable Digits of Upper Limb

Autoren

  • Rajesh Kumar 

    1   Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Jerry R. John

    1   Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Tarush Gupta

    1   Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

  • Ramesh K. Sharma

    1   Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Funding None.
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Abstract

Background Finger amputations aim at preserving function and optimizing cosmesis. The crucial decision here is whether to preserve a stump or to do a ray amputation. The present study aimed to compare the functional outcome and postoperative quality of life after ray amputation or amputation through the proximal phalanx.

Materials and Methods A prospective study was conducted from January 2019 to June 2020 in patients requiring single-finger amputation through the proximal phalanx or metacarpal. Patients were divided into two groups; Group A: amputation through the proximal phalanx and Group B: ray amputation of the finger. The following functional parameters were assessed: grip strength, hand circumference, palmar volume, and webspace span. The Michigan Hand Outcomes Questionnaire (MHQ) score was employed to score hand function and aesthesis at 6 months in both hands.

Results Thirty patients were enrolled. Findings in 26 patients (52 hands) were subjected to further analysis, 12 in Group A and 14 in Group B. Patients in both groups lost grip strength significantly compared with their contralateral normal hands (29.22 ± 14.88 [Group A] and 34.57 ± 19.12 [Group B]); however, it was statistically nonsignificant between the two groups. There was reduced mean palmar circumference in both groups' involved hands, but the decrease in circumference was statistically significant, only for Group B. Group B patients scored better in all the six subscales of the MHQ; however, only the Aesthetics score was significantly superior. The operated hand's webspace span increased significantly with respect to the normal contralateral web by a mean of 4.55 mm.

Conclusion The study concluded that both the surgical options for the level of amputation should be discussed with the patients in detail, taking into account their occupational and personal requirements. Our study findings will help to objectively counsel the patients regarding expectations in functional and aesthetic outcomes following either technique.

Keywords

ray - resection - amputation - digits - comparison - proximal - phalanx - Michigan score - hand grip

Note

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).


Ethical Approval

This study was approved by the Post-Graduate Institute of Medical Education and Research, Chandigarh, India, with Ethics Committee Reference Number INT/EC/2019/000807, dated: April 10, 2019.


Patients' Consent

Informed consent was obtained from all individual participants included in the study.




Publikationsverlauf

Artikel online veröffentlicht:
30. Juli 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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