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A Journal on Forensic Medicine
Minerva Medicolegale 2002 September;122(3): 163-75
Thumb amputation and thumb-index finger pinchingg deficiency in work accidents
Nicolini S., Bomba G., Mazzone V.
The principal diagnostic criteria employed at clinical/symptomatological/instrumental level are reviewed together with the techniques of medico-legal evaluation of the sequelae of traumatic amputations of the thumb insured by INAIL, following reimplantation or microsurgical reconstruction. Amputation of the thumb is, in fact, an absolute clinical indication for reimplantation or microsurgical reconstruction, quite apart from the injury mechanism, the level of amputation and the advanced age of the patient, precisely because of the essential and priority role played by the thumb within the context of overall hand function and, in particular, of the pinching action. Hence the need to have available standard symptomatological tests that are easy to carry out and are built on objective, homogeneous techniques in order to reach an adequate medico-legal evaluation of the effective loss of hand function, an estimate that cannot avoid making an agreed assessment of residual capacities. To conclude, the purpose of the authors is to provide a starting point on which to base a method for assessing the damage (due to the amputation and to reimplantation or microsurgical reconstruction of the thumb) that is sparked off by a deductive judgement and synthesis of single injury-creating components, at the same time taking into due consideration the patient's residual abilities.