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FRANCHISE

Project Title: Finger Replantation ANd amputation-CHallenges in assessing Impairment, Satisfaction and Effectiveness (FRANCHISE) Study

Principal Investigator: Kevin Chung, MD, MS

Clinical Coordinating Center: The Plastic Surgery Foundation

Project Description: More than 90 percent of all amputations in the United States are traumatic digit amputations and they disproportionately affect younger, working-age individuals. Surgical treatment of these injuries includes either replantation of the amputated digit or revision amputation. Long-term outcomes following replantation and revision amputation are not well described in literature and only few comparative studies have been performed.

FRANCHISE study compared the outcomes in digit amputation patients treated with finger amputation vs finger replantation, for the purpose of determining factors influencing the decision to amputate or reconstruct following finger trauma. The study also evaluated whether patient-reported outcome questionnaires accurately measure the level of impairment and disability as it relates to hand function and patient's quality of life. Nineteen US and international sites participated in this study. The findings of this study were published in the following journals:

  • Patient-reported and functional outcomes after revision amputation and replantation: The FRANCHISE multicenter, international, retrospective cohort study. JAMA Surg. 2019 Apr 17. doi: 10.1001/jamasurg.2019.0418.
  • Reliability and validity of upper extremity patient-reported measures in assessing traumatic finger amputation management.Plast Reconstr Surg. 2020 Jan;145(1):94e-105e.
  • Cost-effectiveness of Finger Replantation Compared with Revision Amputation. JAMA Netw Open. 2019 Dec 2;2(12):e1916509
  • Assessment of Tree-Based Statistical Learning to Estimate Optimal Personalized Treatment Decision Rules for Traumatic Finger amputations. JAMA Netw Open. 2020 Feb 5;3(2):e1921626
  • Patient-Reported Outcomes after Digit Replantation and Revision Amputation: When is Maximum Recovery Attained? J Hand Surg Eur Vol. 2020 Oct 20:1753193420965393. doi: 10.1177/1753193420965393. Online ahead of print.PMID: 33081573