Brenner P, Axmann H D, Berger A
Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Medizinischen Hochschule Hannover.
Chirurg. 1993 Mar;64(3):185-9.
Multidigital amputations represent a challenging problem with regard in restoring optimal sensomotoric hand function. Often orthotopic finger stumps or the separated digits are unfit for conventional replantation. This condition is an imperative indication for transpositional replantation. Among 24 heterotopic replantations the survival rate was 82 percent. The favorable finger transfer was a pollizisation, followed by a substitution of the middle finger and finally creating an expanding opposite grip on the ulnar site of the hand. Secondary corrective procedures have been performed in 37.5 percent. To evaluate the global hand function score systems according to Millesi or Tamai have been applied. 65 percent presented a "good" subjective and objective hand function as to Tamai. However the regain of hand function has to be aspired much more in the single and individual case of transpositional replantations when compared to the Millesi-score system.