[One stage total thumb reconstruction using MP II joint pollicisation] and free transfer of distal part of great toe: report of two cases].
Indications, treatment and late results of thumb reconstruction in two males aged 28 and 29 are presented. The thumbs had been amputated on the level of the middle first metacarpal with concomitant amputation in the middle of proximal phalanx of the index. Besides, one of the patients lost all other fingers in this hand. Reconstructions of the thumbs were carried out in the third and sixth months after the injury using pollicisation of the index stump and transferring free distal part of the trimmed great toe. FHL and EHL tendons were left intact. Some complications were observed in one of the patients. The complications included: spasm of the vein in the recipient site on the second day after the operation, wound dehiscence on the foot on the tenth day and nonunion of the index phalanx. Another surgery using bone graft was necessary. Grip reconstruction in one patient with metacarpal hand needed additional two toes to hand transfer. Results of the treatment were evaluated 8 and 6 years after the reconstruction. The new reconstructed thumbs were very similar to those on the contralateral hands with good sensation and sufficient movement (40 and 60 degrees of the flexion) to obtain strong and precise grip.
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Klinika Chirurgii Plastycznej, Centrum Medycznego Kształcenia Podyplomowego w Warszawie.
D000328:Adult; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013933:Thumb / Q000601:surgery*; D014034:Toes / Q000601:surgery*
Totalna rekonstrukcja kciuka z wykorzystaniem policyzacji stawu MP II i przeniesieniem obwodowej cześci zwezonego palucha--opis dwóch przypadków.