J Hand Microsurg 2017; 09(02): 092-094
DOI: 10.1055/s-0037-1605353
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Survival Rate of Limb Replantation in Different Age Groups

Masahiro Tatebe
1   Department of Hand Surgery, Nagoya University School of Medicine, Showaku, Nagoya, Japan
,
Shiro Urata
2   Hand and Microsurgery Center, Anjo Kosei Hospital, Anjo, Japan
,
Kenji Tanaka
2   Hand and Microsurgery Center, Anjo Kosei Hospital, Anjo, Japan
,
Toshikazu Kurahashi
2   Hand and Microsurgery Center, Anjo Kosei Hospital, Anjo, Japan
,
Shinsuke Takeda
2   Hand and Microsurgery Center, Anjo Kosei Hospital, Anjo, Japan
,
Hitoshi Hirata
1   Department of Hand Surgery, Nagoya University School of Medicine, Showaku, Nagoya, Japan
› Institutsangaben
Weitere Informationen

Publikationsverlauf

08. Juni 2017

05. Juli 2017

Publikationsdatum:
31. Juli 2017 (online)

Abstract

Revascularization of damaged limbs/digits is technically feasible, but indications for surgical replantation remain controversial. The authors analyzed the survival rate of upper limb amputations and the associated factors in different age groups. They grouped 371 limb/digit amputees (average age, 44 years; range, 2–85 years) treated in their hospital during the past 10 years into three groups based on age (young, ≤ 15 years, n = 12; adult, 16–64 years, n = 302; elderly, ≥ 65 years, n = 57) and analyzed their injury type (extent of injury and stump status), operation method, presence of medical complications (Charlson comorbidity index), and survival rate. There were 168 replantations, and the overall replantation survival rate was 93%. The Charlson comorbidity index of the replantation patients was 0 in 124 cases; 1 in 32; 2 in 9; and 3 in 3, but it did not show any significant difference in survival rate after replantation. Eight elderly patients (14%) did not opt for replantation. Younger patients tended to undergo replantation, but they had lower success rates due to their severe injury status. The results of this study show that the survival rate of replantation in elderly patients is equal to that in adults. Stump evaluation is important for survival, but the presence of medical complications is not associated with the overall survival rate.

 
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