Metacarpal-Like and Metacarpal Hand

Reconstructive Principles for the Metacarpal Hand: Case Report

“…However, this decision must be adapted to the patient's occupation, daily activity, degree of motivation, and esthetic concerns. [1][2][3][4][5][6] The initial care should focus on tissue preservation and skin coverage, but the former cannot be conditioned by the latter. An effort is made to preserve certain structures that will condition the reconstruction outcome, as well as to lower the morbidity at the donor area, 2 including neurovascular structures, metacarpophalangeal joints, the trapeziometacarpal joint, and thenar muscles.…”

“…For the type-I metacarpal hand, the transfer of two triphalangeal fingers of the foot is usually enough. 1,2,4,5 Type-II metacarpal hand requires a functional thumb, usually to transfer the first toe to that position. In turn, two triphalangeal fingers are required for the transfer.…”

“…2,6 The transfer of two second toes to the third and fourth radii allows a correct balance between the gripper capacity and the grasp of objects and tools. 2,4 Toe transfer to the fourth and fifth radii is warranted in patients with high demand for grasp tools (construction workers, carpenters etc.) and no need for a precise grip.…”

“…Surgeons must consider the urgent treatment, the conditions for a satisfactory deferred surgery, and the surgical indication starting at the first contact; in addition, it is critical to know the different alternatives and to never forget that the reconstruction plan must consider the patient's requirements. [1][2][3][4][5][6]…”

Classification of Post-Traumatic Defects and Deformations of the Hand and Foreum in Children: Pathology With Loss of Distal Segments of the Hand

“…Развитие микрохирургических технологий значительно расширило возможности восстановления пальцев кисти, в том числе и у детей [4][5][6]. Прогресс этого направления хирургии позволил разработать и внедрить в клиническую практику принципиально новые и весьма эффективные операции, позволяющие одномоментно замещать дефекты тканей больших размеров и различной локализации, а также восстанавливать утраченные в результате травм фрагменты кисти и предплечья [6][7][8].…”