title: [Functional improvement in the treatment of large soft tissue defects of the thumb by a free tissue transplant].
abstract: The advantages of free transplantation used to cover defects of the thumb are demonstrated with the aid of a clinical example. A 27 years old patient had lost large parts of the covering soft tissue as well as the nerves and vessels on the flexor side of the distal phalanx of his left thumb. After a single wound toilet the thumb could hardly be used because of the reduced mechanical resistance to stress, the missing sensibility and a severely disturbed circulation. This kind of large soft tissue defect at a functionally important location can now be covered with a free composite tissue transplantation. We took a neurovascular flap out of this patient's forefoot and anastomosed it with the vessels and nerves of the proximal phalanx of the thumb. After an uncomplicated healing the covering soft tissue could be mechanically stressed and was well supplied with blood. Three month later a beginning sensibility can be proved. After 2 years the fully rehabilitated patient shows a good functional result with a two-point discrimination of 10 millimeters.
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D013933:Thumb / Q000098:blood supply / Q000293:injuries / Q000294:innervation / Q000601:surgery* / Q000637:transplantation; D014182:Transplantation, Autologous
vernacular_title: Funktionelle Verbesserungen in der Versorgung grosser Weichteildefekte am Daumen durch eine freie Gewebeübertragung.