As stated by the Chinese Surgeons, "Survival without restoration of function is not success", the replantation should not only succeed but also ensure a proper function of the replanted hands and digits.
This retrospective study included 258 patients to whom replantations of digits or hands were performed between January 1986 and December 1990.
Eighty-six patients underwent the secondary operation for further functional recovery.
Their problems were classified as tendon dysfunction, joint stiffness, scar contracture, malunion & nonunion, and sensory abnormality in the order of frequency. And the functional recovery could be improved by the secondary operation for each problem.
The authors achieved an increasein the ratio of total excellent or good functional recovery from 55.4% to 72.9% on the long-term follow-up results.
In conclusion, a good functinal recovery is expected in tendon dysfunction by tenolysis, tendon graft, secondary tenorrhaphy or shortening of tendon. A better functional recovery can be achieved in joint stiffness by open capsultomy and artificial joint insertion rather than closed capsulotomy and arthroplasty with the perichondral graft. Scar contracture, malunion & nonunion and sensory abnormality after replantation can be improved by secondary operations.
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