Rodeo Thumb: To Replant or Not




Davis, Justin Joe

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OBJECTIVE: To investigate patient reported outcomes after surgical treatment of Rodeo Thumb to help guide clinical decision making at the time of injury. METHODS: A retrospective review was performed for all rodeo thumb amputations from 2009-2019. Outcomes measured included daily functionality determined by QuickDASH scores, roping ability, and overall satisfaction. These were then compared between different levels of injury and definitive treatment. Outcomes between older and younger patients were also compared. Two-sided t-tests were used for QuickDASH scores and Pearson's Chi square test for categorical data. RESULTS: Thirty-seven patients underwent replantation or amputation as definitive treatment. IP level injury patients treated with replantation had a lower average QuickDASH than those treated with amputation (1.36 vs. 8.11; p=0.07), but fewer were roping at the same level or better (40% vs 78.6%; p=0.262). Patients with MCP level injury treated with replantation also had an average QuickDASH less than those treated with amputation (7.32 vs 10.4; p=0.52) and were roping at same level or better (66.6% vs 55.6%; p=1.00). Younger patients had lower QuickDASH scores than older patients (5.53 vs. 8.19; p=0.42), more who were roping at the same level or better (100% vs. 53%; p=0.02), and more who were satisfied with their treatment decision (88.9% vs. 60.7%; p=0.22.). CONCLUSIONS: For IP level injury, amputation seems to result in the same or better roping abilities as replantation. Replantation is the preferred treatment for MCP level injury. Younger patients tend to have better outcomes, possibly due to increased adaptation to injury. LEVEL OF EVIDENCE: IV

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