Reconstruction of the thumb with a free wrap-around flap from the big toe and an iliac-bone graft.
Ten patients with an amputated thumb had reconstruction by a free wrap-around flap taken from the big toe, including the nail, and an iliac-bone graft as the core of the reconstruction. The long-term results showed that a better replica of the thumb was achieved. The results were quite satisfactory both cosmetically and functionally, but there were some new problems: resorption of the bone graft, bulging of the pulp, skin atrophy at the base of the thumb, and deformity of the nail in a few patients. Modifications of the flap design and of the shape of the bone graft eliminated these problems nearly entirely.
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D001862:Bone Resorption / Q000000981:diagnostic imaging; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006214:Hallux; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries* / Q000601:surgery