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Journal of Hand Surgery (British and European Volume)
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Articles

Replantation–Revascularization and Primary Amputation in Major Hand Injuries

Resources Spent on Treatment and The Indirect Costs of Sick Leave in Sweden

J. HOLMBERG
B. LINDGREN
R. JUTEMARK

From the Departments of Hand Surgery and Community Medicine, University Hospital, Malmö Sweden

Correspondence: J. Holmberg MD, Department of Hand Surgery, University Hospital in Malmö, S-20502, Malmö, Sweden.

Thirty consecutive patients with amputation or devascularizing injuries of the thumb or two or more fingers proximal to the PIP joint were reviewed. Replantation or revascularization had been done in 27 patients, in 24 successfully. Three patients had primary amputation. The distribution of calculable costs was dominated by those for sick leave (49%), operation (26%) and ward costs (20%). Out-patient care, physiotherapy and travel together constituted only 6%. The cost of a successful replantation was equal to 1.6 times the mean annual salary of these patients and that of primary amputation about half as much. Mobility, power and performance of a standardized grip test were better for the successfully replanted or revascularized patients. Subjective evaluation of 23 parameters of function, cosmesis and quality of life did not disclose any differences. All patients except three had returned to their original work within 2 years.

Journal of Hand Surgery (British and European Volume), Vol. 21, No. 5, 576-580 (1996)
DOI: 10.1016/S0266-7681(96)80134-3
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