[Results of reconstruction of the thumb by emergency pollicization of mutilated index finger].
Traumatic amputations of the thumb are frequently associated with mutilation of one or more of the remaining digits. The most common digital injuries associated with thumb loss are partial or complete amputation of the index finger. This was the case in 7 of our patients (men, 37.3 years of age on average), who had had emergency pollicization of the mutilated index finger performed. In 4 patients the palmar neurovascular bundles, in one dorsal metacarpal artery were used for this procedure. In 2 patients, because of lesion of digital blood circulation caused by a trans-metacarpal wound, a two-stage procedure was performed. There were no complications, but 3 secondary reconstructive procedures in the same number of patients were performed. Early rehabilitation was favored by bone fixation of the first metacarpal with tension-band wire. All these patients were re-examined with a minimum 10 months follow up. Six of the patients resumed an active work. The results were evaluated according to opposition, two-point discrimination. Discrimination sensibility was 8mm or less in 5 patients, protective sensibility was observed in 2 patients, cortical integration with reference to the recipient thumb on stimulation of the pollicized segment was adequate in all of the patients. Five patients could achieve tip-to-tip contact between the thumb and the little finger, 2 between the thumb and the most radial finger. The results show that this procedure conversing a useless, mutilated finger into a functioning one is an interesting option for amputations of the thumb occurring in manual workers at the level of or above the MP joint.
Jabłecki
Jerzy
J
Oddział Chirurgii Urazowo-Ortopedycznej i Replantacji Kończyn, Szpital im. św. Jadwigi Slaskiej w Trzebnicy.
Paruzel
Maciej
M
Domanasiewicz
Adam
A
D000328:Adult; D000673:Amputation, Traumatic / Q000503:physiopathology / Q000601:surgery*; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005385:Fingers / Q000503:physiopathology / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012677:Sensation; D013933:Thumb / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome