Outcomes of Finger Replantation in Western Nepal: An Observational Study.

INTRODUCTION

Hand injuries involving finger amputations prevalent in young working populations. This study evaluated the demographics and clinical outcomes of finger replantation procedures performed at a regional referral center in Western Nepal.

METHODS

This retrospective,observational, cross-sectional study was conducted at the Department of Burns, Plastic and Reconstructive Surgery, Charak Memorial Hospital, Pokhara, from January 2023 to December 2024. Ethical approval was obtained from National Health Research Council on 16 February 2025 (Reference no:1840). All patients who underwent finger replantation procedure with successful artery and venous flow restoration were included. Data on demographics, injury characteristics, surgical techniques, and outcomes were collected. Survival was defined as digit viability for a minimum of 21 days. Functional outcomes were assessed using the Chen functional scoring system at 6 months.

RESULTS

A total of 10 finger replantation procedures were performed in 10 patients with mean age of 34.6 ±13.60 years. All patients were male and right-handed. Six (60%) patients were employed in blue-collar occupations. The thumb was commonly affected digit accounting for 6 (60%) cases. The principal mechanism of injury was crush amputation observed in 7 (70%) cases. Five (50%) replanted fingers were categorized as Tamai level III. Successful replantation was achieved in 8 (80%) fingers. Functional assessment revealed Grade I outcomes in 6 (75%) cases and Grade III in 2 (25%) cases.

CONCLUSIONS

Finger replantation in a resource-limited setting achieved survival rates comparable to international standards. Success was attributed to younger patient age, shorter ischemia time, and appropriate surgical techniques.