Outcomes of Digit Replantation in Children: A Systematic Review
Bibliographic record
Abstract
Background: Children have been suggested to benefit from digit replantation due to a greater neurogenerative capacity. We aimed to conduct a systematic review on digit replantation in children to provide a comprehensive overview of survival rates and functional outcomes. Methods: A systematic literature search was conducted on Ovid MEDLINE, Embase, and the Cochrane Controlled Register of Trials for studies published between 1980 and 2023. We included peer-reviewed studies reporting on digit survival rates in pediatric patients under the age of 18 years who underwent single or multiple digit replantations distal to the metacarpophalangeal joint. Preoperative, intraoperative, and postoperative outcomes were extracted, and pooled estimates were derived using univariable analysis. Results: Twenty-two studies reporting on 761 patients and 814 digit replantations were included in our study. Most replantations occurred in the index (n = 74), Tamai zone I (n = 168), and from clean-cut injuries (n = 190). The mean survival rate was 76% (n = 618/814), with a mean range of motion at the distal interphalangeal joint ranging from 64 degrees to 90 degrees and two-point discrimination ranging from 3.8 mm to 6.4 mm. Compared with clean-cut injuries, digit replantations from avulsion [odds ratio (OR), 0.81; 95% confidence interval (CI), 0.74-0.89] or crush (OR, 0.71; 95% CI, 0.59-0.82) injuries were associated with a lower odds of survival. Digit replantations performed with two venous (OR, 1.43, 95% CI; 1.28-1.59) or arterial anastomoses (OR, 1.65; 95% CI, 1.48-1.81) were associated with a higher odds of survival. Conclusions: Our systematic review suggests that digit replantation may be a viable option in children. Further research is required to explore functionality after digit replantation in diverse pediatric populations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".