Doctoral study questions standard practices for finger reattachment in Finland

A recent doctoral study challenges current medical practices regarding reattachment of severed fingers. Joonas Pyörny, a licensed medical practitioner, found that reattaching detached fingers may not always be advisable. In Finland, dozens of accidents involving severe hand injuries occur each year, primarily due to wood-splitting machines. Typically, there are two treatment options: restoring circulation and surgical reattachment of the severed tissue, or what is known as revision amputation. In amputation cases, the soft tissue deficits of the damaged limb are covered, and the wound is closed. Reattachment has become a standard treatment for traumatic upper limb amputations, particularly in accidents involving one or two fingers.

However, Pyörny notes that the evidence supporting the benefits of reattachment over revision amputation is limited and inconsistent. Surprised by his findings, he reported that the complex reattachment surgery did not result in better functionality, quality of life, cold tolerance, or appearance of the hand compared to revision amputation.

“Successfully reattached finger functionality rarely returned to pre-accident levels,” he highlighted. “Reattached fingers often remain stiff, weak, and painful.”

Pyörny suggests that more research is needed to identify patient groups that could benefit from surgery, pointing out that substantial benefits may be seen in extensive thumb injuries as opposed to injuries affecting the little finger or ring finger.

Joonas Pyörny’s dissertation, titled “Treatment Outcomes of Traumatic Upper Extremity Amputations,” will be publicly defended at the Faculty of Medicine and Health Technology at the University of Tampere on Friday, August 9.