RESEARCH ARTICLE Replantation versus Prosthetic Fitting in Traumatic Arm Amputations: A Systematic Review

Background Traumatic arm amputations can be treated with replantation or surgical formalization of the stump with or without subsequent prosthetic fitting. In the literature, many authors suggest the superiority of replantation. This systematic review compared available literature to ana-lyze whether replantation is functionally and psychologically more profitable than formaliza-tion and prosthetic fitting in patients with traumatic arm amputation. Methods Functional outcome and satisfaction levels were recorded of patients with amputation levels below elbow, through elbow, and above elbow. Results Functional outcomes of 301 replantation patients and 172 prosthesis patients were obtained. In the replantation group, good or excellent functional scores were reported in 39 % of above elbow, 55 % of through elbow, and 50 % of below elbow amputation cases. Nearly 100 % of patients were satisfied with the replanted limb. In the prosthesis group, full use of the prosthesis was attained in 48 % of above elbow and in 89 % of below elbow ampu-tation patients. Here, 29 % of patients elected not to use the prosthesis for reasons including pain and functional superfluity. In both replantation patients and prosthesis wearers, a below elbow amputation yielded better functional results than higher amputation levels. Conclusions Replantation of a traumatically amputated arm leads to good function and higher satisfac-tion rates than a prosthesis, regardless of the objective functional outcome. Sensation and psychological well-being seem the two major advantages of replantation over a prosthesis