Reconstruction of traumatic or congenital amputation of the thumb by distraction-lengthening.
Reconstruction of the traumatically or congenitally amputated thumb presents a significant challenge. The individual needs of the patient must be matched with the armamentarium available to the surgeon. Metacarpal elongation via the distraction-lengthening technique, which uses local tissue without sacrificing any adjacent digits or toes, is a reliable means of increasing thumb length by 3 to 3.5 cm. The optimal situation for performing this procedure is the presence of an amputation in the perimetacarpophalangeal joint region. Although neo-osteogenesis has been shown to be useful in pediatric patients, bone grafting is recommended in those individuals aged 25 years and older with gaps of 3 cm or more. The patient must be carefully observed during the distraction period because of the potential problems that may arise from the use of an external fixation device.
Moy
O J
OJ
State University of New York, Buffalo.
Peimer
C A
CA
Sherwin
F S
FS
D000673:Amputation, Traumatic / Q000601:surgery*; D001852:Bone Lengthening / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications; D013518:Surgery, Plastic / Q000379:methods; D013933:Thumb / Q000002:abnormalities / Q000293:injuries / Q000601:surgery*