One-stage thumb lengthening with use of an osteocutaneous 2nd metacarpal flap

1st Orthopaedic Department of Aristotle University of Thessaloniki, "G. Papanikolaou" General Hospital, 57010, Exohi, Thessaloniki, Greece, .
Strategies in Trauma and Limb Reconstruction 11/2009; 4(3):135-9. DOI: 10.1007/s11751-009-0074-z
Source: PubMed


Traumatic thumb amputation represents an extremely disabling entity, thus rendering its reconstruction a procedure of paramount importance. A case of a patient, who sustained a traumatic amputation of his left index finger at the metacarpophalangeal joint and of his left thumb in the middle of the proximal phalanx 4 months ago and was initially treated elsewhere, is described. For the thumb reconstruction, an osteocutaneous flap of the radial side of the 2nd metacarpal, which consisted of a 3, 5-cm bony segment with the overlying skin and its blood and nerve supply was used. The flap was transferred and fixed with a plate and screws to the palmar-medial side of the stump of the thumb, while the 1st web space was deepened by removing the rest of the second metacarpal, while a partial skin graft was used to cover a remaining gap. Thumb functionality was restored immediately postoperatively, and the overall result was satisfactory.

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Available from: Konstantinos Ditsios, Oct 01, 2015
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    ABSTRACT: Many options exist for the management of post-traumatic thumb reconstruction. While the single most important factor for determining the most appropriate procedure is the level of the amputation, many other factors must be considered including patient considerations regarding function and cosmesis as well as the nature of the injury and the expertise of the surgeon. Patients must be included in the decision-making process and their needs and expectations must be clearly defined and addressed. The patient who is most concerned with cosmesis rather than function is more likely to be satisfied with a prosthesis than with even the most cutting-edge surgical procedure.
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