EVALUATING THE OUTCOMES OF THUMB DISTAL SEGMENT MICROSURGICAL REPLANTATION ON WOUND HEALING IN ATHLETES

Abstract

Objective: To evaluate the efficacy of microsurgical replantation for distal thumb amputations in athletes, focusing on wound healing, functional recovery, and quality of life improvements. Methods: This retrospective study reviewed 146 cases of athletes with distal thumb amputations treated at our hospital from January 2020 to December 2021. Participants were divided into two groups based on the surgical technique employed: the control group (n=74) underwent conventional digital replantation, while the observation group (n=72) received microsurgical digital replantation. Outcomes measured included replantation survival rates, sensory and functional recovery of the thumb, aesthetic outcomes, postoperative complications, and overall quality of life, assessed via standardized tools like the SCL-90 and Barthel Index. Results: Survival rates were comparable between the two groups, with 91.67% in the control group and 91.89% in the observation group (P > 0.05). However, the observation group showed significantly better outcomes in terms of pain, thumb appearance, tactile and discriminative sensation, and overall tactile integrity (P < 0.05). Additionally, this group experienced fewer postoperative complications and reported better psychological and functional status post-surgery (P < 0.05). Univariate analysis identified critical factors influencing the success of replantation, including age, operation duration, and type of injury. Notably, warm ischemia time ≥6 hours, non-sharp instrument injuries, age ≥45 years, and operation time ≥2.5 hours were determined as independent risk factors for decreased replantation survival (P < 0.05). Conclusion: Microsurgical replantation for distal thumb amputations in athletes significantly enhances functional and sensory recovery while reducing complications and improving life quality. Key risk factors identified for replantation failure include extended ischemia, age, and longer operation times. These findings underscore the need for tailored surgical approaches to optimize recovery and facilitate quicker return to sports activities for athletes experiencing such traumatic injuries.