Moberg Modification using the First Web Space: Thumb Reconstruction Following Distal Amputation

Thibaudeau, Stéphanie; Tremblay, Dominique; Tardif, Michèle; Chollet, André

doi:10.1007/s11552-012-9406-4

Cited by 8 publications

(9 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moberg’s original flap has been reported to advance as much as up to 1 to 1.5 cm 5 . For this reason, modifications have been described 6,7 . In the present study, we describe a modification to the flap, using a V-Y flap over the distal part of the flap to achieve greater advancement, avoiding flexion contractures.…”

mentioning

confidence: 89%

See 1 more Smart Citation

V-Y Flap Over Moberg’s Flap to Cover the Thumb’s Fingertip Injury: Technique and Cases

Díaz¹,

Vergara-Amador²,

Castro³

2023

Techniques in Hand &Amp; Upper Extremity Surgery

View full text Add to dashboard Cite

The Moberg flap has been used to achieve coverage of amputations of the thumb’s fingertip. However, it has been associated with flexion contractures of the interphalangeal (IP) joint of the thumb. A modification of the surgical technique is presented, adding a distal V-Y flap to allow greater advancement, and avoiding IP joint contractures. The proposed surgical technique is presented, and a case series of patients treated with this modification is introduced. A total of 5 patients underwent this surgical technique. All the flaps healed without complications. No patient presented stiffness or flexion contracture of the thumb´s IP joint. There were no cases of neuropathic pain and the 2-point discrimination over the flap was 6.8 mm on average. In conclusion, the proposed variation to the Moberg’s flap allows adequate coverage of injuries to the thumb’s fingertip with a low rate of complications, adequate sensitivity of the reconstructed digit and avoiding flexion contractures of the IP joint.

show abstract

mentioning

confidence: 89%

“…5 For this reason, modifications have been described. 6,7 In the present study, we describe a modification to the flap, using a V-Y flap over the distal part of the flap to achieve greater advancement, avoiding flexion contractures. As far as the authors know, this modification has not been previously reported.…”

mentioning

confidence: 99%

V-Y Flap Over Moberg’s Flap to Cover the Thumb’s Fingertip Injury: Technique and Cases

Díaz¹,

Vergara-Amador²,

Castro³

2023

Techniques in Hand &Amp; Upper Extremity Surgery

View full text Add to dashboard Cite

show abstract

“…They are extended proximally to cut across a point in the line drawn from the radial border of the middle finger to the wrist (►Figs. [1][2][3][4].…”

Section: Surgical Techniquementioning

confidence: 99%

Revisiting Elliot's Modification of Moberg's Flap and Our Improvisation

Jayachandiran,

Rajendran,

Mahipathy

et al. 2024

Indian J Plast Surg

View full text Add to dashboard Cite

Thumb tip injuries constitute one of the most common hand injuries. There are various reconstructive options for thumb tip injuries. We present our series of thumb tip injuries reconstructed using Elliot's modiﬁcation of the Moberg ﬂap, which provides like-for-like tissue. We also present our flap improvisation, which can be useful in the armamentarium of plastic surgeons. Background Moberg described the advancement ﬂap for thumb defects in 1964, which was modiﬁed by O'Brien in which the proximal part of the ﬂap is incised and advanced. Although it is a popular ﬂap, it has the disadvantage of interphalangeal (IP) joint ﬂexion deformity. Among the various modiﬁcations of the Moberg ﬂap, Elliot's ﬂap provided more tissue with minimal donor site morbidity and no usage of skin grafts or ﬁrst web skin. Methods We retrospectively analyzed the patients who underwent reconstruction of thumb defects by Elliot's modified Moberg's ﬂap. The size of the defect, etiology, and IP joint movement were analyzed. Two patients underwent our improvised ﬂap where a daughter ﬂap was elevated within Elliot's ﬂap. Results Between January 2021 and September 2023, 12 patients underwent reconstruction by Elliot's ﬂap. All ﬂaps settled well. There was no IP joint deformity. Two patients had scar hypertrophy that was managed conservatively. Conclusion Elliot's modification of the Moberg ﬂap is a very useful but underutilized ﬂap for thumb tip injuries that provides like tissue with sensation and with little donor site morbidity. It can be used for thumb tip defects of up to 3 cm. It is possible to incorporate a second V-Y ﬂap in patients for whom additional movement is required for tension-free closure.

show abstract

“…Although the O'Brien flap allows more distal advancement, it comes at the cost of a full-thickness donor site over the proximal portion of the volar thumb, leaving the neurovascular bundles exposed. This secondary defect can be skin grafted, but various authors have also described lateral triangular flaps or more proximal V-Y advancement to cover this donor site [10][11][12] . Other modifications to the Moberg include carrying the longitudinal incisions more proximally over the thenar eminence, or placing Z-plasties at the base of the flap to increase advancement.…”

Section: Introductionmentioning

confidence: 99%