We describe a modification of the cross finger flap procedure. The modification enhances the amount of soft tissue under the flap, permitting reconstruction of the nail bed where necessary. We present two clinical cases.
Toe-to-hand transfer is a well established procedure and is one of the best ways of reconstructing the missing fingers or parts of fingers. In congenital deformities of fingers and hands such as absence of digits, second toe transfer may create the grip function and is superior to all other procedures. We present three cases of four second toe transfer to reconstruct long finger defects after congenital malformations of the long fingers. The aim of this paper is to discuss some aspects of the procedure and to evaluate achieved results. All our four patients were operated on when they were over 10 years of age.
Anatomical examination of the blood-vessels in the distal phalanges of the foot show that the arteries and veins of this region are thick enough to be anastomosed by microsurgical means. This makes it possible to perform free toe-to-hand transfer, reconstructing defects of the distal phalanx and suturing arteries and veins at the level of the middle or even distal phalanxes. Eleven distal parts of the fingers have been reconstructed. All the transfers were successful, and good cosmetic and functional results were obtained.
Santrauka. Dviskiltis (bi-lobed, bilobed) odos rotacinis lopas yra gana gerai žinomas veido defektams padengti, ypač tose veido vietose, kur didesnis odos ir minkštųjų audinių tempimas. Dažniausiai dviskiltis lopas naudojamas nosies nugarėlės, nosies galiuko ir viršugalvio defektams uždengti. Ilgainiui dviskiltis odos rotacinis lopas vis dažniau pradėtas naudoti ir kitose kūno vietose. Pateikiame du retesnius klinikinius atvejus, kai, atlikus odos ir poodžio patologinių darinių eksciziją pakinklio ir krūtinės ląstos srityse, reikėjo padengti gana didelius odos defektus. Abiem atvejais panaudotas dviskiltis lopas, kuris įgalino pirmine siūle susiūti susidariusius audinių defektus ir donorines vietas.Reikšminiai žodžiai: dviskiltis odos lopas, rotaciniai lopai, dideli odos defektai.Abstract. The bi-lobed skin rotational flaps are commonly used mainly to cover facial tissue defects on the nasal tip and dorsal side, also on head areas, where skin and surrounding tissues are tight. Recent literature shows that the bi-lobed flap is used to cover defects in other body areas as well.This report shows two clinical cases where the bi-lobed flap was used to cover large skin and soft tissue defects after the excision of pathologically damaged skin and soft tissue lesions of the popliteal and the chest area. In both cases the recipient areas were adequately covered, and donor sites were closed primarily.
A 40-year-old patient presented with traumatic amputation of the thumb and index finger. The second metacarpal bone fragment was transposed to lengthen the first metacarpal bone. A free flap from the lateral forearm was used to reconstruct the thenar region. Later, the second free toe-to-hand transfer was done from which he made a good recovery, achieving active flexion and extension in all joints.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.