Composite Osteocutaneous Groin Flap Combined with Neurovascular Island Flap for Thumb Reconstruction

2003 ◽  
Vol 28 (5) ◽  
pp. 399-404 ◽  
Author(s):  
F. PARMAKSIZOGLU ◽  
T. BEYZADEOGLU
Keyword(s):  
Bone Resorption ◽  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Island Flap ◽  
Bone Block ◽  
Thumb Reconstruction ◽  
Groin Flap ◽  
Three Phase ◽  
Bone Scans

Three amputated thumbs were reconstructed with a composite osteocutaneous groin flap and a neurovascular island flap. The average age at the time of surgery was 28 (range 25–35) years. The level of the amputation was distal to metacarpophalangeal joint in two cases and proximal in one case. The injury mechanism was avulsion in all cases. The postoperative follow-up periods ranged from 27 to 30 months. There were no cases of skin necrosis, bone resorption or infection. Radiographs and three-phase bone scans showed union of the iliac bone block and the stump without any resorption in all three patients. This surgical procedure is reliable and simple and the functional results are satisfying. We reserve this technique for the treatment of thumb amputations which cannot be replanted, particularly as it does not result in bone resorption.

scholarly journals Metacarpophalangeal Arthrodesis with Resection-suspension Arthroplasty in First Carpometacarpal Osteoarthritis

2020 ◽  
Vol 48 (01) ◽  
pp. 027-030
Author(s):  
Jose A. Oteo-Maldonado ◽  
Patricia Merino-Carretero
Keyword(s):  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Wilcoxon Test ◽  
Carpometacarpal Joint ◽  
Medium Term ◽  
Hand Grip ◽  
First Carpometacarpal Joint ◽  
Quick Dash ◽  
Carpometacarpal Osteoarthritis

AbstractFirst carpometacarpal joint osteoarthritis (CMC-1) may develop first metacarpophalangeal joint hyperextension (MCP-1). We enrolled patients with CMC-1 osteoarthritis and MCP-1 hyperextension ≥40 degrees treated with resection-suspension arthroplasty and MCP-1 intramedullary arthrodesis with XMCP™ system. Minimum follow-up was five years. We evaluated: thumbinterphalangeal (IP) range ofmotion, key pinch, hand grip, Kapandji, VAS and Quick DASH. Wilcoxon test was uses for statistical analysis.Nineteen patients were reviewed. We found improvement in key pinch, hand grip, VAS and Quick DASH; statistical difference (p < 0.05) was observed in all of them except key pinch. IF thumb range of motion and Kapandji decreased.TMC arthrodesis with XMCP™ system associated with resection-suspension arthroplasty, as a treatment for CMC-1 osteoarthritis and MCP-1 hyperextension ≥40 degrees, achieves good functional results in the medium term.

A Comparative Study of the Heterodigital Neurovascular Island Flap in Thumb Reconstruction, with and without Nerve Reconnection

1994 ◽  
Vol 19 (5) ◽  
pp. 552-559 ◽  
Author(s):  
R. ADANI ◽  
P. B. SQUARZINA ◽  
C. CASTAGNETTI ◽  
A. LAGANÁ ◽  
G. PANCALDI ◽  
...  
Keyword(s):  
Donor Site ◽  
Functional Results ◽  
Flap Reconstruction ◽  
Hypertrophic Scarring ◽  
Digital Nerve ◽  
Thumb Reconstruction ◽  
Cold Intolerance ◽  
Scar Contracture ◽  
Sensory Acuity

41 heterodigital neurovascular island flaps were used to cover defects of the tactile pad of the thumb in 17 years. With an average follow-up of 75.5 months, 30 patients were reviewed. 17 were treated by the original Littler technique and 13 were treated with the same flap reconstruction but with division of the digital nerve innervating the flap and re-anastomosis of this nerve to the proximal nerve end of the ulnar digital nerve of the thumb. Good aesthetic and functional results were achieved in both groups. Sensory acuity did not appear to decrease with time. The nerve reconnection technique solves the “double sensibility” phenomenon (present in 41.1% of our cases treated by the original technique), but two-point discrimination is less than that achieved by the Littler technique. Most complaints were related to the donor site such as hypertrophic scarring or scar contracture and cold intolerance, but these did not cause any real functional impairment.

Long-term functional results of microvascular toe-to-thumb reconstruction

2010 ◽  
Vol 36 (3) ◽  
pp. 194-204 ◽  
Author(s):  
T. Kotkansalo ◽  
S. Vilkki ◽  
P. Elo ◽  
T. Luukkaala
Keyword(s):  
Recovery Of Function ◽  
Hand Function ◽  
Functional Results ◽  
Inclusion Criteria ◽  
Clinical Tests ◽  
Thumb Reconstruction ◽  
Initial Injury ◽  
Toe Transfer

The purpose of this study was to evaluate the long-term functional results of microvascular toe-to-thumb reconstruction after trauma. Forty-one patients meeting the inclusion criteria were available for a clinical follow-up study. The function of the hand was assessed with questionnaires as well as with modified Tamai and Sollerman hand function tests. According to the questionnaires, most activities were considered easy or quite easy and the majority of the patients (36/41) managed with no or minor complaints. Clinical tests showed good recovery of function. Patient satisfaction was high. There were superficial infections in five hands and in six donor feet. In total, 16 late corrective operations were done to eight patients. Microvascular toe transfer is a good option for grip reconstruction after thumb amputation. The extent of the initial injury influences the achievable outcome, yet even a single toe transfer can restore adequate grip function.

Use of three-phase bone scans and SPET in the follow-up of patients with allogenic vascularized femur transplants

1999 ◽  
Vol 20 (6) ◽  
pp. 517-524 ◽  
Author(s):  
M. H. KIRSCHNER ◽  
N. MANTHEY ◽  
K. TATSCH ◽  
A. NERLICH ◽  
K. HAHN ◽  
...  
Keyword(s):  
Three Phase ◽  
Bone Scans

scholarly journals Dorsal pentagonal island flap to reconstruct post-burn interdigital web

2019 ◽  
Vol 101 (4) ◽  
pp. 290-296
Author(s):  
TOH Prasetyono ◽  
CR Andrian
Keyword(s):  
Metacarpophalangeal Joint ◽  
Scar Tissue ◽  
Island Flap ◽  
Basic Design ◽  
Joint Movement ◽  
Burn Scar ◽  
Flap Design ◽  
One Year ◽  
Flexion And Extension

Introduction This study reports the use of a dorsal pentagonal island flap for post-burn webbing contracture, in which the islanded flap is harvested from the burn scar tissue. Methods Fourteen dorsal pentagonal island flaps were harvested in seven patients with post-burn webbing. Each flap was selected by examining the scar tissue donor using a modified Vancouver scar scale. Modification from the basic design was made according to the density of the donor scar tissue and the metacarpophalangeal joint movement. Results All the flaps survived with normal abduction of the affected fingers. Modification of the flap design needed adjustment by assessing it through flexion and extension of the metacarpophalangeal joints. There was no incidence of web creep after two months to one year of follow-up. Conclusion Dorsal pentagonal island flap shows promising results as an alternative for reconstructing post-burn webbing.

Laparoscopic simple prostatectomy: complications and functional results after five years of follow-up

2020 ◽  
Vol 72 (4) ◽  
Author(s):  
Matteo Manfredi ◽  
Cristian Fiori ◽  
Dario Peretti ◽  
Federico Piramide ◽  
Enrico Checcucci ◽  
...  
Keyword(s):  
Functional Results ◽  
Simple Prostatectomy

Porous tantalum acetabular cups for reconstructions after peri-acetabular resections of primary bone tumours

2021 ◽  
pp. 112070002110015
Author(s):  
Riccardo Zucchini ◽  
Andrea Sambri ◽  
Claudio Giannini ◽  
Michele Fiore ◽  
Carlotta Calamelli ◽  
...  
Keyword(s):  
Bone Tumour ◽  
Hip Dislocation ◽  
Functional Results ◽  
Bone Tumours ◽  
Harris Hip Score ◽  
Porous Tantalum ◽  
Term Survival ◽  
Primary Bone ◽  
Primary Bone Tumours

Introduction: Periacetabular reconstruction after resection of primary bone tumour is a very demanding procedure. They are frequently associated with scarce functional results and a high rate of complications. We report a series of patients with periacetabular resections for primary bone tumours and reconstruction with a porous tantalum (PT) acetabular cup (AC). Materials and methods: 27 patients (median age 30 years) were included, being affected by primary bone tumours of the pelvis and treated with peri-acetabular resection and reconstruction with a PT AC. The diagnoses were 13 osteosarcomas, 7 chondrosarcomas and 7 Ewing sarcomas. Function was assessed with the Harris Hip Score and complications were classified according to Zeifang. Results: The median follow-up was 70 months. 1 patient required removal of the PT AC because of implant associated infection 55 months after surgery. There was 1 hip dislocation and no case of aseptic loosening. At final follow-up, the median HHS was 81 points (range 48–92). Conclusions: The used PT AC had good medium-term survival rates and good functional results. This technique is a viable reconstructive option after resections of periacetabular primary bone sarcomas.

A volar approach to on-top plasty for correction of radial polydactyly: a case series of 21 patients

2021 ◽  
pp. 175319342098185
Author(s):  
Xia Fang ◽  
Ping-tak Chan ◽  
Shengbo Zhou ◽  
Xinyi Dai ◽  
Ruiji Guo ◽  
...  
Keyword(s):  
Case Series ◽  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Contralateral Side ◽  
Average Score ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Volar Approach ◽  
Flexion Extension ◽  
Aesthetic Results

Correction of unequal radial polydactyly in which neither thumb duplicates possess both well-developed proximal and distal components, remains challenging. Current techniques using on-top plasty techniques require circumferential incisions, often resulting in postoperative swelling and dorsal scars. We described our experience using a volar approach to achieve better aesthetic and functional results. Twenty-one patients underwent this surgery between 2008 and 2018, with a mean follow-up of 5.1 years. The mean flexion–extension arc for the metacarpophalangeal joint was 75° and that of the interphalangeal joint was 43°. Mean percentage of key, tripod and tip pinch strength were 77%, 79% and 77%, respectively, when compared with the contralateral side. The Vancouver Scar Scale showed an average score of 1.2. We conclude from our study that the volar approach to on-top plasty is a good technique for the correction of unequal radial polydactyly, with good functional and aesthetic results. Level of evidence: IV

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