title: [On-top plasty. Indications and technic in the reconstruction of severely injured hands].
abstract: The possibilities and advantages of the on-top plasty in the reconstruction of severely damaged hands are described. Based upon ten cases, a classification into four groups is made. In each of these groups different reconstructive procedures are applicable. Group 1: Intact thumb with loss of all fingers.
  
  
  METHODS
  Lengthening of the third metacarpal by on-top-plasty of the distal half of the second metacarpal. This simultaneously widens the first intermetacarpal space. Group 2: Partial amputation of the thumb with severe damage to several fingers.
  
  
  METHODS
  Thumb reconstruction by transposition of two phalanges of an otherwise useless finger. Group 3: Loss of the thumb and of two and a half fingers.
  
  
  METHODS
  Thumb reconstruction by transposition of the remaining basal phalanx. Group 4: Loss of the thumb and of three fingers.
  
  
  METHODS
  Thumb reconstruction by on top-plasty of the distal half of the metacarpals and rotational angulatory osteotomy of the fifth metacarpal.
mesh_terms: D000673:Amputation, Traumatic / Q000473:pathology; D006225:Hand / Q000601:surgery; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008722:Methods; D011184:Postoperative Period
vernacular_title: On Top Plasty, Indikationsstellung und Technik bei der Rekonstruktion schwer verstümmelter Hände.