title: The Use of Composite Tissue Spare Parts to Restore Tripod Hand Function in Post-Traumatic and Congenital Hand Deficiency.
abstract: The principle aim in complex defects in hand is to restore a functioning tripod pinch. Among the various options, the use of locally available spare parts offers to improve both functions and cosmetics. 10 patients underwent surgeries to restore tripod pinch using this concept of spare parts. Four of them were children with congenital differences and the rest were adults with post traumatic defects. Eight of them underwent on-top plasty out of which four underwent an island pedicled transfer of phalanges and the rest involved distraction lengthening and transfer of metacarpals. One patient underwent a vascularized tenocutaneous joint transfer and another, a non-vascularized metacarpal transfer. At last follow up, eight of them were using hand with tripod pinch and one, using a lateral pinch. A carefully planned use of local tissues as spare part results in satisfactory outcome without the need for additional graft material in hands with absent or poor function.
authors.affiliation: † Consultant Orthopedic Surgeon, Hi-tech Hospital, Udupi, India.
authors.forename: Bhaskaranand
authors.initials: B
authors.lastname: Kumar
authors.affiliation: * Unit of Hand and Microsurgery, Department of Orthopedics, Kasturba Medical College Hospital, Manipal University, Manipal, India.
authors.forename: Anil Keshavamurthy
authors.initials: AK
authors.lastname: Bhat
authors.affiliation: * Unit of Hand and Microsurgery, Department of Orthopedics, Kasturba Medical College Hospital, Manipal University, Manipal, India.
authors.forename: Ashwath Madhusudan
authors.initials: AM
authors.lastname: Acharya
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005385:Fingers / Q000637:transplantation*; D006228:Hand Deformities, Congenital / Q000503:physiopathology / Q000601:surgery*; D006230:Hand Injuries / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D052581:Pinch Strength / Q000502:physiology; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
keywords: Distraction; On top Plasty; Spare Parts; Tripod Pinch