The Teleology of the Thumb: On Purpose and Design

Ladd, Amy L.

doi:10.1016/j.jhsa.2018.01.002

Cited by 15 publications

(17 citation statements)

References 64 publications

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“…The teleology of the 1st CMC joint for example, highlights the relationship of form with that of function in the hand. 1 Anomalies in thumb development range from duplication of thumb to total absence of the thumb. Congenital trigger thumb may also be included in anomalies of the thumb, though there is much debate whether triggering is actually congenital or not.…”

Section: Introductionmentioning

confidence: 99%

Congenital thumb differences- current concepts

Thomas¹,

Pallapati²

2020

Journal of Clinical Orthopaedics and Trauma

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Anomalies of the thumb development are not uncommon and may be associated with a number of syndromes also. These anomalies range from total absence to duplication. Reconstructive surgery for the creation of an opposable thumb is the most rewarding aspect of Hand Surgery and also the most challenging. Classification systems have been modified for better description. A number of procedures have been introduced to improve the functionality of the hand in anomalies and age old concepts are undergoing a metamorphosis to further this. A brief description of the common conditions and their treatment are discussed here and highlighted by selected clinical cases.

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Section: Introductionmentioning

confidence: 99%

Congenital thumb differences- current concepts

Thomas¹,

Pallapati²

2020

Journal of Clinical Orthopaedics and Trauma

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“…The thumb is the most vital part of hand function. The ideal thumb reconstruction from a microsurgical toe transfer should meet the requirements of both form and function with minor donor site morbidity [ 11 – 13 ]. Currently, there are four main types of free toe transfers (total great toe, second toe, great toe wrap around, and trimmed great toe) [ 8 , 12 , 14 – 17 ].…”

Section: Discussionmentioning

confidence: 99%

Cosmetic and functional results of a newly reconstructed thumb by combining the phalanx of second toe and the great toenail flap transplantation

Yin

Tao

et al. 2020

J Orthop Surg Res

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Background Microsurgical toe-to-hand transfer is a gold standard when it comes to repairing a thumb defect. Great toenail flap, thumbnail valva flap, free great toe, and second toe transplantation are the common methods in thumb reconstruction. Second toe transplantation achieves good function, but poor esthetics. Great toe transplantation achieves better esthetics, but hindered walking, due to the foot’s loss of the great toe and moreover suboptimal thumb function. It is difficult to maintain both functional and esthetic satisfaction in thumb reconstruction. Methods We experimented with three different methods of toe to hand transfer. From October 2009 to July 2019, 30 patients with traumatic thumb defects received one of 3 different kinds of thumb reconstruction in our clinic according to their level of amputation. Divided evenly into three groups of ten, group one received a great toe transplantation, group two received a second toe transplantation, and group three received a combined great toenail flap and second toe phalanx transplantation. Each of the patients’ thumbs had different levels of amputation at the metatarsophalangeal joint (MPJ) or distal interphalangeal joint (DIPJ). Results One patient suffered from a partial flap necrosis and received a groin flap to cover the defect. No other thumbs had any complications. The functional and esthetic results of both the donor and the recipient sites were satisfactory. Results show that, for patients with traumatic thumb defects, the combined transfer of flap and second toe phalanx was the best option. Conclusions Compared to the great toe or second toe transfer, combined free transfer of the great toenail flap and second toe phalanx achieved a substantially better functional and esthetic result in the thumb reconstruction.

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“…The thumb is the most vital part of hand function. The ideal thumb reconstruction from a microsurgical toe transfer should meet the requirements of both form and function with minor donor site morbidity [11][12][13]. Currently, there are four main types of free toe transfers (total great toe, second toe, great toe wraparound, and trimmed great toe) [8,12,[14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Cosmetic and Functional Results of a Newly Reconstructed Thumb by Combining the Phalange of Second Toe and the Great Toenail Flap Transplantation

Yin

Tao

et al. 2020

Preprint

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BACKGROUND Microsurgical toe-to-hand transfer is a gold standard when it comes to repairing a thumb defect. Great toenail flap, thumbnail valva flap, free great toe and second toe transplantation are the common methods in thumb reconstruction. Second toe transplantation achieves good function, but poor aesthetics. Great toe transplantation achieves better aesthetics, but hindered walking, due to the foot’s loss of the great toe and moreover suboptimal thumb function. It is difficult to maintain both functional and aesthetic satisfaction in thumb reconstruction.METHODS We experimented with three different methods of toe to hand transfer. From October 2009 to July 2019, 30 patients with traumatic thumb defects received one of 3 different kinds of thumb reconstruction in our clinic according to their level of amputation. Divided evenly into three groups of ten, group one received a great toe transplantation, group two received a second toe transplantation, and group three received a combined great toenail flap and second toe phalange transplantation. Each of the patients’ thumbs had different levels of amputation at the metatarsophalangeal joint (MPJ) or distal interphalangeal joint (DIPJ). RESULTS 1 patient suffered from a partial flap necrosis and received a groin flap to cover the defect. No other thumbs had any complications. The functional and aesthetic results of both the donor and the recipient sites were satisfactory.CONCLUSIONS Compared to the great toe or second toe transfer, combined free transfer of the great toenail flap and 2nd toe phalange achieved a substantially better functional and aesthetic result in the thumb reconstruction.

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The Teleology of the Thumb: On Purpose and Design

Cited by 15 publications

References 64 publications

Congenital thumb differences- current concepts

Congenital thumb differences- current concepts

Cosmetic and functional results of a newly reconstructed thumb by combining the phalanx of second toe and the great toenail flap transplantation

Cosmetic and Functional Results of a Newly Reconstructed Thumb by Combining the Phalange of Second Toe and the Great Toenail Flap Transplantation

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