Osteoplastic Thumb Ray Restoration with or without Secondary Toe Transfer for Reconstruction of Opposable Basic Hand Function

Lin, Chih‐Hung; Mardini, Samir; Lin, Yu‐Te; Lin, Chih-Hung; Chen, Chien-Tzung; Wei, Fu‐Chan

doi:10.1097/01.prs.0000302457.59356.fc

Cited by 23 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The follow‐up period ranged from 6 to 63 months (mean period, 34.8 months). Two patients who underwent thumb reconstruction with free RF flaps (patients 5 and 6) achieved opposable basic hand function (Kapandji grade 10) 20. In comparison with the normal side, the average recovery of key pinch function was 97.9% and that of grasping function was 96.4%.…”

Section: Resultsmentioning

confidence: 96%

Free fasciocutaneous flaps for reconstruction of complete circumferential degloving injury of digits

Lin

Chen

et al. 2012

Microsurgery

View full text Add to dashboard Cite

Complete circumferential degloving injury of the digits usually results in a large cutaneous defect with tendinous structure and bone and joint exposure. When revascularization is not possible, a thin and adequately sized flap is required to resurface the defect, restore finger function, and prevent amputation. In this report, we present our experience with reconstruction of the entire circumferential degloving injury of the digits using free fasciocutaneous flaps. Between February 2006 and January 2011, 9 male patients with circumferential degloving injury of 9 digits underwent reconstruction using free fasciocutaneous flap transfer with the posterior interosseous artery flap, medial sural artery flap, anteromedial thigh flap, or radial forearm flap. The average flap size was 14.2 × 6.9 cm. Donor sites were closed primarily or covered with split-thickness skin graft. All flaps survived completely and the donor sites healed without complications. The mean follow-up period was 34.8 months. A maximum Kapandji score (10/10) was seen in 2 cases with crushed thumbs. All patients could achieve good key pinch and grasping functions. All skin flaps showed acceptable static 2-point discrimination and adequate protective sensation. Patient satisfaction for resurfaced digits averaged 9 on a 10-points visual analogic scale. In conclusion, the free fasciocutaneous flaps used were thin and did not interfere with finger movements. The patient's finger formed a smooth contour and acceptable functional results were obtained after reconstruction. This method may be a valuable alternative for reconstruction of entire circumferential avulsion injury of the digits.

show abstract

Section: Resultsmentioning

confidence: 96%

Free fasciocutaneous flaps for reconstruction of complete circumferential degloving injury of digits

Lin

Chen

et al. 2012

Microsurgery

View full text Add to dashboard Cite

show abstract

“…В литературе описаны несколько сов ременных вариантов кожно-костной реконструкции I пальца. Чаще всего мягкотканный компонент представлен несвободным паховым лоскутом, а в качестве костной основы используют фрагмент гребня подвздошной кости [17,18,19]. Описаны также единичные случаи кожно-костной реконструкции с применением других кровоснабжаемых сложных комплексов тканей, которые поз воляют восстановить палец путем выполнения одного вмешательства: свободного кожно-костного латерального лоскута плеча [20], островкового кожно-костного комплекса тканей на второй тыльной пястной артерии [21], островкового кожно-костного лоскута предплечья на задней межкостной артерии [22].…”

Section: результатыunclassified

Osteo-Cutaneous Reconstruction of the Thumb by Radial Composite Flap

Rodomanova

2024

Traumatology and Orthopedics of Russia

View full text Add to dashboard Cite

Background. One of the possible ways of the thumb reconstruction when it is lost at the level of the middle third of the ray is osteo-cutaneous reconstruction, which today is carried out by transplantation of the blood-supplied composite tissue complex, which allows for reconstruction of the lost thumb without the risk of the bone graft resorption. The aim — to evaluate the effectiveness of osteo-cutaneous reconstruction of the thumb using a blood-supplied tissue complex based on the radial artery. The study is based on the results of the treatment of 27 patients who underwent the thumb reconstruction with a radial osteo-cutaneous tissue complex performed according to the G. Foucher’ technique. The average age of the operated patients was 44±12.7 years. The island tissue complex was used in 22 patients; in 5 cases, a free flap from another forearm was transplanted. Results. Long-term results were evaluated one year after reconstruction. In all cases, good functional results were achieved with an average DASH score of 44.4±10.6 points. The best results were obtained in patients with a stump at the base of the thumb proximal phalanx due to the preservation of the metacarpophalangeal joint mobility, the average volume of movements of which was 45°. When using Littler’s flap, it is possible to achieve a 2PD of the working surface of the restored thumb within 7.5±0.9 mm. Otherwise, only the protective sensitivity is restored. Conclusions. The osteo-cutaneous reconstruction of the thumb when it is absent at the level of the middle third of the ray is an effective method of reconstruction if it is impossible to use other microsurgical methods, such as transplantation of the second toe or the fragment of the great toe.

show abstract

“…As long as the thumb is intact and phalangeal bone is reconstructed, opposition and pinch function of the thumb can be achieved. 1,2 Moreover, the second to the fifth fingers are more likely to be damaged by press machineries and grinders because these fingers are longer. When a mutilating hand injury accompanying multiple amputation occurs, extensive amount of soft tissue including bones are lost, and there is no alternative but to perform stump revision mostly by shortening.…”

mentioning

confidence: 99%

Reverse On-Top Plasty in Mutilating Hand Injuries

Sohn

Han²,

Jung³

2014

Annals of Plastic Surgery

View full text Add to dashboard Cite

For crushing injury of the hand that involves 4-digit amputations sparing the thumb, lengthening of amputated stump and covering the defect are important for hand function. From March 2007 to September 2011, the authors performed "reverse on-top plasty" in 5 patients. The fifth metacarpal bone was disarticulated, turned over 180 degrees, and embedded in reverse direction so that the metacarpal base becomes the tip of new finger. Soft tissue defects were covered using anterolateral thigh free flap or reverse radial forearm flap. The mean follow-up period was 21.2 months, and major complications such as bony resorption did not occur. Static 2-point discrimination showed fair recovery of fingertip sense. Key pinch power was 76.4% of the uninjured hand. In conclusion, reverse on-top plasty is good in gaining more sufficient finger length and durability using cartilaginous portion of the fifth metacarpal bone than the previously used on-top plasty.

show abstract

Osteoplastic Thumb Ray Restoration with or without Secondary Toe Transfer for Reconstruction of Opposable Basic Hand Function

Abstract: Osteoplastic thumb ray reconstruction followed by osteotomies or sensate flap transfers can yield satisfactory results for some patients. Optimal functional outcomes are achieved when osteoplastic thumb ray reconstruction is followed by toe transfer.

Cited by 23 publications

References 14 publications

Free fasciocutaneous flaps for reconstruction of complete circumferential degloving injury of digits

Free fasciocutaneous flaps for reconstruction of complete circumferential degloving injury of digits

Osteo-Cutaneous Reconstruction of the Thumb by Radial Composite Flap

Reverse On-Top Plasty in Mutilating Hand Injuries

Contact Info

Product

Resources

About