Two-stage toe-to-thumb reconstruction in pollicized second metacarpal and useless fingers.
A case of a 25-year-old, male farm worker with a history of traumatic amputation of the right first ray, complete absence of the first metacarpal, and every phalanx of the second finger is presented. A two-stage surgical reconstruction was planned, initially, with transfer of the second metacarpal to the trapezium, creating the first web space which was covered with skin from a reverse radial forearm flap. The second stage included transfer of the right big toe to the hand with anastomoses of the first dorsal metatarsal artery to the radial artery (end-to-end) and the veins to the radial vena comitans and cephalic vein in the flap (reverse flow). Functional and cosmetic results were excellent. The physiologic considerations of reverse flow are discussed.
Plastic Surgery Service, Hospital General de Mexico, Mexico D.F, Mexico.
N
N
Sastre
M I
MI
Caravantes
C
C
Mayoral-Garcia
D000328:Adult; D000673:Amputation, Traumatic / Q000601:surgery*; D005385:Fingers / Q000601:surgery*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000601:surgery*; D013933:Thumb / Q000601:surgery*; D014034:Toes / Q000637:transplantation*