Thumb Reconstruction after Severe Trauma Using the Masquelet Technique and the Foucher Neurovascular Flap

Abstract

Summary: Complex injuries of fingers with bone and soft tissue loss often result in amputation. We present here a case of thumb reconstruction in a severely injured thumb with bone and dorsal soft tissue loss. Primarily a radical debridement of devascularized tissue was performed and a spacer was implanted, to ensure tissue decontamination and induce a Masquelet’s bone membrane. After 6 weeks the spacer was replaced with autologous cancellous bone and a pedicled Foucher neurovascular flap was used to augment the soft tissues. Eight months postoperatively the patient showed a great outcome with thumb length preservation, excellent range of motion and aesthetics. This novel technique facilitates finger and especially thumb preservation without the risk of infection. The Masquelet technique can hereby be safely used for reconstruction of finger injuries and the microsurgical flap coverage can be postponed for the secondary procedure, without compromising the bone regeneration.

Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap—a case report

“…Large bony defects of the tibia can be reconstructed by the Masquelet technique, by bone transport, or by vascularized bone transplantation [ 3 ]. While the free vascularized fibula flap is a well-known technique to bridge large bone gaps, the pedicled fibula transplantation is also a feasible technique, without inducing supplementary donor site morbidity in the contralateral leg [ 4 ].…”

Lower leg reconstruction after resection of a squamous cell carcinoma on necrobiosis lipoidica with a pedicled fibula and an extended anterolateral thigh flap – A case report

“…Large bony defects of the tibia can be reconstructed by the Masquelet-Technique, by bone transport, or by vascularized bone transplantation [3]. While the free vascularized bula ap is a well-known technique to bridge large bone gaps, the pedicled bula transplantation is also a feasible technique, without inducing supplementary donor site morbidity in the contralateral leg [4].…”