Single Ray Amputation for Tumors of the Hand |
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Authors: | Mark Edward Puhaindran John H Healey Edward A Athanasian |
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Institution: | (1) Orthopaedic Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA |
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Abstract: | Single ray amputation after hand trauma or infection can result in good aesthetic and functional outcomes. The role of this
procedure in the management of aggressive benign or malignant hand tumors has been described only in case reports and small
case series. We retrospectively reviewed the records of all 25 patients who underwent single ray amputations at our center
during a 10-year period; there were seven index, five middle, six ring, and seven small ray amputations performed. The minimum
followup was 2 months (mean, 36 months; range, 2–120 months), with four patients having a followup of 1 year or less. No patients
had local recurrences, although two patients had positive resection margins. One underwent repeat resection followed by radiotherapy.
The other was treated with radiotherapy alone, as local tumor control would have required a hand amputation. Functional assessment
based on the Musculoskeletal Tumor Society staging system showed an average of 27.5 (range, 21–30). Patients who underwent
perioperative radiotherapy experienced a decrease in functional ability. Grip strength was an average of 66% (range, 38%–100%)
of the contralateral side. Our study suggests single ray amputation for hand tumors has a low local recurrence rate and high
functional scores. However, function can be compromised by radiotherapy and a decrease in grip strength by a mean of 34% is
to be expected. |
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