Comparison of Outcomes for Distal Upper Extremity Amputations Between Plastic Surgeons and Orthopedic Surgeons: A Retrospective Study

Abstract

Objective: To compare the outcomes of patients undergoing distal upper extremity
amputations within 30 days of surgery.
Methodology: We conducted a retrospective study using data from the hospital’s HIMS
database, covering the years Oct 2018 to Oct 2023. Approval from the institutional review
committee was obtained before the commencement of the study. We included patients who
underwent surgery for an upper extremity amputation by either an orthopedic or plastic
surgeon. Specific surgery numbers were used to identify the type of amputation: forearm, wrist
and finger. Surgeries to revise a previous amputation were excluded from this study.
Results: Out of 680 patients included in the study, 58.08% (n=395) had surgery by orthopedic
surgeons and rest of the 41.92 (n=285) by plastic surgeons. In both the groups, most surgeries
were for finger amputations. Interestingly, there wasn't a significant difference in the types of
surgeries performed by orthopedic surgeons compared to plastic surgeons. On average, plastic
surgery procedures took slightly longer than those performed by orthopedic surgeons (52
minutes vs. 38 minutes). This difference was statistically significant, but the actual difference
in time (around 5 minutes) is unlikely to have a major impact on patient outcomes.
There were no significant differences between the two surgeon groups in terms of the urgency
of the surgeries (emergency vs. planned), whether patients stayed overnight in the hospital, or
the condition of the wounds after surgery.
Conclusion: Plastic surgeons and orthopedic surgeons achieved similar results in terms of
complications within the first 30 days after surgery (perioperative complications) for patients
undergoing hand, wrist, or finger amputations (distal upper extremity amputations). This
suggests that both specialties can provide equally high-quality care for these procedures.
Keywords: amputations, Hand fellowship training, Outcomes, Orthopedics, Plastics