The Aesthetic Mini Wrap-Around Technique for Thumb Reconstruction (original) (raw)
Related papers
2020
BACKGROUND Microsurgical toe-to-hand transfer is a gold standard when it comes to repairing a thumb defect. Great toenail flap, thumbnail valva flap, free great toe and second toe transplantation are the common methods in thumb reconstruction. Second toe transplantation achieves good function, but poor aesthetics. Great toe transplantation achieves better aesthetics, but hindered walking, due to the foot’s loss of the great toe and moreover suboptimal thumb function. It is difficult to maintain both functional and aesthetic satisfaction in thumb reconstruction.METHODS We experimented with three different methods of toe to hand transfer. From October 2009 to July 2019, 30 patients with traumatic thumb defects received one of 3 different kinds of thumb reconstruction in our clinic according to their level of amputation. Divided evenly into three groups of ten, group one received a great toe transplantation, group two received a second toe transplantation, and group three received a co...
2013
Amputation at the proximal phalanx or at the metacarpophalangeal joint can be treated by pollicization of a finger, osteoplastic reconstruction, free microvascular transfer of a toe, or distraction lengthening. The best technique to use to treat these cases depends on the place of amputation and the patient's age, sex, occupation and functional demands. In the past 6 years, we treated 4 patients by lengthening the thumb metacarpal ray and adding a mini wraparound flap from the great toe. All the subjects were female with an average age of 22 years. All 4 patients had sustained traumatic amputations: 2 at the metacarpophalangeal joint and 2 at the base of the proximal phalanx. Distraction was completed approximately 65 days after osteotomy, obtaining an average lengthening of 23 mm. To achieve bone consolidation, the lengthener was left in place for 127 days on average. Microsurgical thumb reconstruction was performed around 3 months after consolidation of the osteotomy. There were no failures or cases of postoperative vascular compromise. The average pinch power was 66% of the opposite hand. The static 2-point discrimination of the reconstructed thumb was 8 mm (range, 7-10 mm). All patients reported being satisfied with the treatment, although 1 patient was partially dissatisfied due to the prolonged length of the treatment. Donor site morbidity was minimal. This procedure is mainly chosen by selected patients who refuse standard microsurgical thumb reconstruction because it requires a longer treatment period
The Journal of Hand Surgery, 2018
Thumb amputation at the carpometacarpal level is very incapacitating. Pollicization may be considered. We describe an alternate technique for thumb reconstruction at the level of the metacarpal base using a trimmed great toe along with a vascularized second metatarsophalangeal joint, including the second metatarsal, all supplied on a single vascular pedicle. Two patients who had a combined soft tissue defect and amputation of the thumb close to the carpometacarpal joint were reconstructed with this method. A transposition of the second toe was performed on top of the remaining proximal phalanx of the great toe to decrease donor site morbidity. This technique provides adequate length to the thumb without compromising another finger by creating a new thumb using a double microsurgical toe transfer on a single vascular pedicle. We minimize donor site morbidity by transposing the second toe onto the great toe.
Versatility of the Cross-Finger Flap for Reconstruction of the Thumb Corresponding author
2017
The thumb is responsible for 40% of the hand function. Therefore, when resurfacing of the thumb is required, cross-fi nger flap may prove very useful. In this paper, we reported three cases where cross-fi nger flaps were used successfully in order to cover soft tissue defects of the thumb`s distal phalanx. No major complications were encountered. All patients were satisfi ed with the cosmetic aspect of the reconstruction procedure (9 on VAS). All the fi ngers were fully functional, with a mean TAM score of 266° for the donor fi ngers and a mean DASH score of 2.16 after 1 year from injury. Using this technique, we obtain good quality soft and bulky tissue to restore the original form of the thumb in order to prevent function loss by reducing length and primary suture of the fi nger. Therefore, we consider this method very effective in covering vital structures with almost no morbidity related to the donor site. Alongside other previous papers describing this technique, we concluded t...
Versatility of the Cross-Finger Flap for Reconstruction of the Thumb
2017
1 “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2 Department of Plastic Surgery and Reconstruction Microsurgery, Clinical Emergency Hospital of Bucharest, Romania 3 Department of Plastic and Reconstructive Surgery, “Prof. Dr. Agrippa Ionescu” Clinical Emergency Hospital, Bucharest, Romania Corresponding author: Tiberiu Paul Neagu, Assistant Professor, MD, PhD Department of Plastic Surgery and Reconstructive Microsurgery, Emergency Clinical Hospital, 8 Floreasca Avenue, 1st District, Bucharest, Romania. E-mail: dr.neagupaul@gmail.com Abstract
Workhorse flaps for thumb reconstruction
Plastic and Aesthetic Research, 2022
Posttraumatic thumb defects result in significant functional impairment. Multiple reconstructive procedures have been described for the management and improvement of function. Compared with no treatment, all reconstructive methods are beneficial. Each of the available procedures may be more applicable under certain conditions, can offer great benefits, and have its own downsides as well. With a thorough assessment and meticulous technique, the results of thumb reconstruction can be excellent. We present a review of the current reconstructive procedures for traumatic thumb amputation.