Distal Amputation of the Fingers
Conditions
Keywords
annoying pulpal dysesthesia, lipofilling, amputation, sequelae
Brief summary
The purpose of this study is to evaluate the contribution of autologous graft reinjection (lipofilling) in the treatment of dysaesthesic pulp.
Interventions
PROCEDUREautologous transplant reinjection
The patient is placed under loco-regional anesthesia. After sterilization of the upper limb and abdomen, the fat is removed at a fold by micro-incision by the Coleman method. The fat is decanted and micro-reinjected into the pulp of the patient's finger with 2 or 3 punctiform incisions. The quantity of fat injected is 2 to 3 mL. Incision of the abdomen and fingers is closed by points at monocryl 4/0. Finally, a fatty dressing is performed on the finger. Patients will benefit from nursing care every 2 days
OTHERdesensitization
Patients will have to stimulate the pulp of your finger on a daily basis
Sponsors
University Hospital, Brest
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
The randomization list is established by the Brest CHRU data management unit before the start of the trial. Based on a ratio (1: 1) with stratification on the center, the type of initial surgery (directed or flap scarring) and the duration of change of dysesthesia (≤ or\> 1 year at baseline).
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Major patient (18 years old) and ≤ 75 years old * Patient with unidigital trauma downstream of distal interphalangeal joint * Treated by directed healing OR covered by a flap * Presenting troublesome pulpal dysesthesia evolving for more than 6 months AND less than 24 months * The discomfort must be objectified by a DN4 score greater than or equal to 4/10 (neuropathic pain) * Patient does not have any allergy to the substances used, in particular anesthetic: xylocaine, adrenaline
Exclusion criteria
* Patient with cutaneous sepsis, or amputation upstream of distal interphalangeal, or reimplantation, or dysesthesia that has been in progress for more than 24 months, or multi-digital traumatism * Refusal of the patient to integrate the protocol Or incapacity to consent * Pregnant or breastfeeding woman * Tumor history of the amputated finger
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Decrease of the EVA between D0 and M6 | Day 0, Month 6 | visual analogue scale from 0 to 10, knowing that 0 is the absence of discomfort and intolerable discomfort |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Subjective self-assessment of the overall functional ability of both upper limbs | Day 0, Day 15, Month1, Month3, Month6 | DASH questionnaire (Disability of Arm-Shoulder-Hand) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Neuropathic pain | Day 0, Day 15, Month 1, Month 3, Month 6 | DN4 score (questionnaire) : a score greater than or equal to 4 makes the diagnosis of neuropathic pain. |
| Patient satisfaction on the esthetic aspect of the finger | Month 6 | Subjective satisfaction to the patient's appreciation. |
Countries
France
Contacts
Primary ContactAnne PERRUISSEAU-CARRIER, Dr
Outcome results
None listed