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Friday, December 19, 2014
Ray amputation of LRF
Hi. 4 years ago, I suffered severe fractures to the dip and pip joints in my LRF. I had 2 reconstructive surgeries, joint replacement and tendon release surgeries. I have been suffering swelling in the joint with the replacement. X-ray reveals the upper part of the artificial joint has migrated and is close to a 90 degree angle. My Dr. has suggested a ray amputation. Mentally this is the only one of my surgeries that has bothered me. Can you give me some insight and information on this surgery. Thanks.
As you may know, a "ray amputation" in your case means removal of a metacarpal bone along with the digit (finger) in line with it. The reason this has been recommended - rather than amputation of the ring finger without also removing the metacarpal - should be discussed with your physician. For your information, removing just the ring finger would:
- leave a space through which small objects could pass when this hand is used as a cup or in a scooping maneuver, and
- cause your small finger to deviate toward your long finger.
Eliminating a gap between your long and small fingers by removing the 4th metacarpal along with the ring finger would thereby improve hand function, despite the resulting reduction in hand width.
If after discussing your questions - including pros and cons, risks and anticipated benefits of, and any alternatives to the proposed surgery - with your physician, you need further insight and information regarding ray amputation, you may wish to seek a second opinion from another hand surgeon who's also had experience performing partial hand amputations.
Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University