Osteoplastic Reconstruction for Post Traumatic Thumb Amputations Around Metacarpophalangeal Joint

Segu, Smitha S; Athavale, Swapna Nachiket; Manjunath, Peddi

doi:10.7860/jcdr/2015/14334.6404

Cited by 6 publications

(8 citation statements)

References 6 publications

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“…In the current era of microsurgery, pedicled 10 This has been documented by the experience of several authors with abdominal and groin flaps. 1,2,10,11 Since the initial description of TUF by Taylor et al, 4 many authors have described its clinical utility in various regions of the upper limb. [12][13][14][15] It was termed as paraumbilical flap by several authors.…”

Section: Discussionmentioning

confidence: 99%

Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery

Naalla

Dawar

et al. 2018

J Hand Microsurg

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Section: Discussionmentioning

confidence: 99%

Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery

Naalla

Dawar

et al. 2018

J Hand Microsurg

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“…Osteosynthesis of bone fragments was carried out mainly by using pins (16). In addition, osteosynthesis was also performed by using pins in combination with the insertion method (9). Bone grafts were transplanted together with an islet skin-fat flap (a small "sentinel" one or that capable of replacing large defects in accordance with the type of the graft and the condition of the skinseptal vessels) with the formation, as a rule, of a muscular sleeve.…”

Section: Methodsmentioning

confidence: 99%

“…These approaches are still rarely used. Isolated cases of transplantation of a bone fragment from the lateral edge of the scapula, iliac wing, metatarsal fragment, or tibia crest have been reported; however, these reports have little clinical and anatomical rationale [1][2][3][4][5][6][7][8][9]. In most cases, the authors do not have adequate clinical material and do not provide long-term treatment results.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of Fingers Using Skin-Bone Grafts with Microvascular Anastomoses

et al. 2020

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The aim of the study was to present a clinical and anatomical rationale for transplantation of skin-bone grafts with microvascular anastomoses for treating terminal and segmental defects of the hand and fingers. Materials and Methods. Finger and metacarpal bones were reconstructed in 25 hands of 25 patients by transplanting skin-bone tubular fragments with microvascular anastomoses. Transplants from the second metatarsal bone (n=22) and fibula (n=3) were used. Clinical, radiological, morphological, biomechanical, biophysical, and statistical research methods were used. The developed technology is adjustable to individual vascular anatomy of the foot. The proposed use of non-free skin-fat flaps and skin-bone fragments with microvascular anastomoses has been implemented for reconstructing lost segments. Results. The engraftment of skin-bone fragments was observed in 25 cases. In two cases, partial necrosis of the transplants was detected. Sufficient resistance of the transplanted bone graft to resorption was noted. According to the X-ray evidence, the length of the finger with the metacarpal bone after surgery was 8.44±0.32 cm, in the short term after surgery-8.10±0.36 cm, and in the long term-7.87±0.45 cm, indicating mild resorption. We used an individual approach to the transplant selection, which made it possible to obtain generally good long-term results in 3 patients, and satisfactory results-in 22 patients. Conclusion. The study showed the feasibility of transplanting skin-bone fragments with microvascular anastomoses for replacing various anatomical defects of the hand and fingers. The proposed modification takes into account the variability of vascular anatomy of the donor region.

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“…Historically performed in a delayed manner, this technique combines a large piece of autologous cortical bone graft, typically harvested from the iliac crest, with soft tissue coverage by a pedicled groin flap or distally based radial forearm flap. 3 , 11 Here, we present our experience with osteoplastic thumb reconstruction at the time of injury, utilizing the remaining bone from unsalvageable portions of the injured hand coupled with an immediate pedicled groin flap for soft tissue coverage to restore functional length.…”

Section: Introductionmentioning

confidence: 99%

Osteoplastic Thumb Reconstruction in the Immediate Setting: A Case Series

Liu

Miller

Wee

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Traumatic thumb amputation can have devastating effects on residual hand function. When replantation is not possible, thumb reconstruction is often performed in a delayed manner and may require multiple stages. Furthermore, reconstruction techniques often require microsurgical skills and equipment, which are not readily available at all institutions. This case series illustrates our technique for immediate osteoplastic thumb reconstruction following traumatic amputation. Methods: This is a case series involving all patients who sustained unreplantable thumb amputations and underwent immediate osteoplastic thumb reconstruction with bone autograft and pedicled groin flap by the senior author from September 2016 through August 2018. Results: Five patients underwent immediate osteoplastic thumb reconstruction during the study period. Total operative time for the initial osteoplastic reconstruction averaged 158 minutes (range 96–290 minutes). In addition to flap division surgery, patients underwent an average of 1.2 revision procedures (range 0–2), primarily for debulking and hardware removal. Patients achieved an average gain in length of 3.3 cm compared with the maximum anticipated length with revision amputation at the time of injury, and had stable clinical outcomes for a minimum of 12 months. Conclusions: Osteoplastic thumb reconstruction is a useful technique for thumb reconstruction for select patients following traumatic thumb amputation. Advantages of this approach include shorter overall operative times and hospital length of stay, minimal donor site morbidity, and a straightforward, reproducible technique.

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Osteoplastic Reconstruction for Post Traumatic Thumb Amputations Around Metacarpophalangeal Joint

Cited by 6 publications

References 6 publications

Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery

Thoracoumbilical Flap: Anatomy, Technique, and Clinical Applications in Upper Limb Reconstruction in the Era of Microvascular Surgery

Reconstruction of Fingers Using Skin-Bone Grafts with Microvascular Anastomoses

Osteoplastic Thumb Reconstruction in the Immediate Setting: A Case Series

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