Functional assessment and quality of life in patients following replantation of the distal half of the forearm (except fingers): A review of 11 cases

The aims of this study were to evaluate the function and quality of life in patients who have undergone replantation of the hand or forearm. We carried out a retrospective single-center study of cases performed between 1977 and 2015. Our hospital's database was searched for patients who underwent replantation of the distal half of the forearm and hand (except the fingers). The evaluation included sensitivity, joint mobility, strength and quality of life. Conventional functional scores were used. Seventeen replantation cases were identified. Four patients were lost to follow-up. Of the 13 available patients, two suffered a replantation failure. Ultimately 11 patients were included in the study. Three patients were evaluated based on their medical records and eight were reviewed in person. The mean patient age was 31 +/- 11.8 years. The sensory evaluation resulted in five patients being classified as S1 and one as S3+. The mean Kapandji score was 4.3 +/- 2.3 [0-6]. The mean grip strength was 39.4 +/- 20% [0-80], and the pinch strength was 36.2 +/- 16% [0-60] compared to the healthy contralateral side. The mean DASH was 36.2 +/- 30.4 [4.5-79.5]. According to Chen's classification, two patients were at stage IV. For 50% of patients, the overall quality of life was at least equivalent to that of the general population. Replantation of the distal half of the forearm and hand should be attempted whenever possible. Although replantation causes some disability, good quality of life seems to be maintained. (C) 2017 Published by Elsevier Masson SAS on behalf of SFCM.