[Thumb reconstruction with skin and soft tissue expansion].
OBJECTIVE
To evaluate a new reconstruction method for grades V and VI defect with flap by skin soft tissue expansion technique.


METHODS
From May 1998 to September 2003, 8 cases of serious thumb defect were treated, including 6 males and 2 females, aging 18-27 years. The defect was caused by crush injury of machine in 6 cases and hot crush injury in 2 cases (5 cases of grade V and 3 cases of grade VI). The expander was placed under the tenor skin and soft-tissue. And then normal saline was infused to expand the skin and soft tissue gradually till it was available for thumb reconstruction. Iliac autograft was fixed to residual thumb stump and covered with flap produce by expanded skin and soft-tissue. Postoperative rehabilitation was carried out.


RESULTS
All reconstructed thumbs were alive. After 3-24 months follow-up, all reconstructed thumbs were with good sensation, appearance and durable. Two-point discrimination was less than 5 mm. The functions of opposition, extend, abduction and endoduction were better in grade V thumb defect than in grade VI thumb defect. Bone union was achieved within 3 to 4 months.


CONCLUSIONS
It is a convenient-to-operate and reliable method for thumb reconstruction. It is an alternative new reconstruction method for grades V and VI, thumb defect.
Zhao
Xiaowei
X
Department of Hand Surgery, the Songgang People's Hoospital of Shenzhen, Shenzhen Guangdong, P R China. xiaoweizhao2008@163.com
Wang
Wei
W
Han
Yun
Y
D000293:Adolescent; D000328:Adult; D062109:Dermatologic Surgical Procedures; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000601:surgery*; D013933:Thumb / Q000293:injuries / Q000601:surgery*; D015626:Tissue Expansion