Elective cross-hand transfer: a case report with a five-year follow-up.
The elective free microvascular cross-hand transfer of the right hand to the left distal carpus was successfully performed in a 35-year old professional photographer. Traumatic loss of the left hand with preservation of a useful thumb and concomitant right upper extremity injury leaving the right hand with an amputated thumb, but paralyzed and insensate from a brachial plexus palsy 5 years before transfer, set the stage for such a reconstruction. Multiple immediate tendon transfers and primary nerve grafting provided for finger flexion and extension plus functional sensibility in this first reported case of an elective cross-hand microvascular transfer. Five years follow-up demonstrates useful and powerful flexion, and functional extension of digits in the reconstructed left hand and right upper extremity function has been improved with a below-elbow prosthesis.
May
J W
JW
Department of General Surgery, Massachusetts General Hospital, Boston 02114.
Rothkopf
D M
DM
Savage
R C
RC
Atkinson
R
R
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D011182:Postoperative Care; D019736:Prostheses and Implants; D013709:Tendon Transfer; D013933:Thumb / Q000293:injuries / Q000601:surgery