Salvage of sensation in a hallux-to-thumb transfer by nerve tube reconstruction.
We report a patient in whom, at 3 years after successful reconstruction of a right avulsed thumb with a microvascular hallux transfer, the insensate transfer had sensibility restored. The radial sensory and both volar digital nerves of the thumb were reconstructed using 2.3-mm-diameter bioabsorbable neural conduits. At 30 months after reconstruction, static 2-point discrimination of the hallux was 4 mm at 14.7 g/mm(2) in this now 42-year-old right-handed man. The cutaneous pressure threshold for 1-point static touch was 0.7 g/mm(2). There were no painful neuromas at the nerve reconstruction sites.
Dellon
A Lee
AL
Division of Plastic Surgery and Neurosurgery, and the Department of Anatomy, University of Arizona, Tucson, AZ, USA. aldellon@delloninstitute.com <aldellon@delloninstitute.com>
Maloney
Christopher T
CT
D020341:Absorbable Implants; D000328:Adult; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods; D009416:Nerve Regeneration; D009431:Neural Conduction; D010543:Peroneal Nerve / Q000601:surgery*; D011826:Radial Nerve / Q000601:surgery*; D016879:Salvage Therapy; D013933:Thumb / Q000293:injuries / Q000294:innervation / Q000601:surgery*; D014034:Toes / Q000294:innervation* / Q000637:transplantation*