Microsurgical treatment for bilateral thumb defect: five case reports.
The authors present a new and efficient treatment for reconstruction of bilateral defective thumbs by different configured toe-tissues transplantations in a single stage, including bilateral second-toe transfer in 2 cases, bilateral hallux wrap-around flap transfer in 1 case, bilateral modified hallux wrap-around flap transfer in 1 case, and combined second toe with island flap with neurovascular pedicles from the proximal and dorsal aspect of the index finger transfer in 1 case. In total, eight transferred tissues survived uneventfully after circulation monitor and medicine administration according to the rules of microsurgery, and in two other transferred toe tissues, temporary circulation crises occurred. Over a 1-year follow-up, the satisfactory appearance and excellent function of the reconstructed bilateral thumbs were noted. For ensuring the success of the procedure, the authors emphasize the establishment of a double artery supply and venous return-flow systems and the modification of the hallux wrap-around flap dissection and tendon repair. Meanwhile, three-stage systemically functional rehabilitations also improved functional restoration of reconstructed thumbs.
Xu
Lei
L
Department of Hand Surgery, Hua Shan Hospital, Fudan University, Shanghai, People's Republic of China.
Gu
Yu-dong
YD
Xu
Jian-guang
JG
Rui
Yong-jun
YJ
Shou
Kui-sui
KS
D000062:Accidents, Occupational; D000328:Adult; D000673:Amputation, Traumatic / Q000175:diagnosis / Q000601:surgery*; D016025:Bone Transplantation; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008866:Microsurgery / Q000379:methods*; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D012494:Sampling Studies; D013524:Surgical Flaps; D013933:Thumb / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology