Personalized Treatment Decisions for Traumatic Proximal Finger Amputations: A Retrospective Cohort Study

Overview

Journal J Pers Med

Date 2023 Feb 25

PMID 36836449

Authors

Nadjib Dastagir

Doha Obed

Khaled Dastagir

Peter M Vogt

Affiliations

Soon will be listed here.

Abstract

Ray and proximal phalanx amputations present valid surgical options for the management of severe traumatic finger injuries. However, among these procedures, the superior one for optimal functionality and quality of life for patients still remains unknown. This retrospective cohort study compares the postoperative effects of each amputation type to provide objective evidence and to create a paradigm for clinical decision-making. A total of forty patients who had received either ray or proximal phalanx-level amputations reported on their functional outcomes using a combination of questionnaires and clinical testing. We found a decreased overall DASH score following ray amputation. Particularly, Part A and Part C of the DASH questionnaire were consistently lower compared with amputation at the proximal phalanx. Pain measurements in the affected hand were also significantly decreased during work and at rest in ray amputation patients, and they reported decreased cold sensitivity. Range of motion and grip strength were lower in ray amputations, which is an important preoperative consideration. We found no significant differences in reported health condition, evaluated according to the EQ-5D-5L, and blood circulation in the affected hand. We present an algorithm for clinical decision-making based on patients' preferences to personalize treatment.

Citing Articles

Blood Vessel Injuries of the Fingers: A Clinical Comparison of One- and Two-Arterial Blood Supply.

Dastagir N, Obed D, Bucher F, Murad S, Dastagir K, Vogt P J Clin Med. 2023; 12(18).

PMID: 37762830 PMC: 10531927. DOI: 10.3390/jcm12185889.

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