Reconstruction of the Thumb after Traumatic Tissue Loss

2018 ◽  
Author(s):  
James E Clune ◽  
Neil F Jones
Keyword(s):  
Key Words ◽  
Tissue Loss ◽  
Human Hand ◽  
Traumatic Amputation ◽  
Thumb Reconstruction ◽  
Fine Manipulation ◽  
Individual Needs ◽  
Toe Transfer

The distinctive prehensile functions of the human hand are orchestrated by the thumb. Without a thumb, the hand lacks critical movements allowing for pinch, grasp, and fine manipulation. Based on the patient’s individual needs, occupation, and desires, thumb reconstruction should be offered to every patient with a traumatic amputation. Position, stability, mobility, and sensation command attention when reconstructing the absent thumb. We present the spectrum of various techniques available for reconstructing a useful thumb. This review contains 9 figures, 3 tables and 51 references.  Key words: Thumb; reconstruction, amputation, pollicization, toe transfer, metacarpal lengthening, webspace deepening

scholarly journals TOE TO THUMB TRANSFER

2012 ◽  
Vol 19 (06) ◽  
pp. 877-883
Author(s):  
Muhammad AZEEM ◽  
TAHSEEN AHMED CHEEMA ◽  
MUHAMMAD ZAFAR IQBAL
Keyword(s):  
Vascular Reconstruction ◽  
Early Rehabilitation ◽  
Human Hand ◽  
Microvascular Reconstruction ◽  
Dominant Hand ◽  
Traumatic Amputation ◽  
Minor Complication ◽  
Male And Female ◽  
Conventional Methods ◽  
Toe Transfer

Introduction: Thumb is the most important part of human hand both functionally and cosmetically. The reconstruction of lostthumb is always challenging for the surgeons. Objectives: The aim of study is to evaluate the results of micro – vascular reconstruction ofthumb by toe transfer. Place and duration of study: B. Victoria hospital Bahawalpur from January 1998 to December 2008. Material andmethod: Both male and female patients who presented to the orthopedic Department with traumatic amputation of thumb were included in thestudy. Results: All ten thumbs survived with minor complication as for as functionally and cosmetically are assessed. Dominant hand wasinvolved in eight cases. Conclusions: Results of Microvascular reconstruction are much better as compared to conventional methods. This issingle stage procedure and early rehabilitation of hand is possible. Cosmetically and functionally this is far superior to conventional methods.

Reversal of Cortical Reorganization in Human Primary Motor Cortex Following Thumb Reconstruction

2010 ◽  
Vol 103 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Zhen Ni ◽  
Dimitri J. Anastakis ◽  
Carolyn Gunraj ◽  
Robert Chen
Keyword(s):  
Motor Cortex ◽  
Primary Motor Cortex ◽  
Short Interval ◽  
Body Part ◽  
Cortical Reorganization ◽  
Traumatic Amputation ◽  
Motor Threshold ◽  
Thumb Reconstruction ◽  
Intact Side ◽  
Injured Side

Deafferentation such as the amputation of a body part causes cortical reorganization in the primary motor cortex (M1). We investigated whether this reorganization is reversible after reconstruction of the lost body part. We tested two patients who had long-standing thumb amputations followed by thumb reconstruction with toe-to-thumb transfer 9 to 10 mo later and one patient who underwent thumb replantation immediately following traumatic amputation. Using transcranial magnetic stimulation, we measured the motor evoked potential (MEP) threshold, latency, short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF) at different time points in the course of recovery in abductor pollicis brevis muscle. For the two patients who underwent late toe-to-thumb transfer, the rest motor threshold was lower on the injured side than that on the intact side before surgery and it increased with time after reconstruction, whereas the active motor threshold remained unchanged. The rest and active MEP latencies were similar on the injured side before and ≤15 wk after surgery and followed by restoration of expected latency differences. SICI was reduced before surgery and progressively normalized with the time after surgery. ICF did not change with time. These physiological measures correlated with the recovery of motor and sensory functions. All the measurements on the intact side of the toe-to-thumb transfer patients and in the patient with thumb replantation immediately following traumatic amputation remained stable over time. We conclude that chronic reorganization occurring in the M1 after amputation can be reversed by reconstruction of the lost body part.

Penile Reconstruction

2019 ◽  
Author(s):  
Afaaf Shakir ◽  
Shane D Morrison ◽  
Christopher S Crowe ◽  
Gordon K Lee
Keyword(s):  
Key Words ◽  
Sexual Intercourse ◽  
Patient Outcomes ◽  
Congenital Anomalies ◽  
Traumatic Amputation ◽  
Perineal Reconstruction ◽  
Transgender Surgery

Total penile reconstruction aims to either reestablish a functioning phallus in men who have suffered traumatic amputation or are born with congenital anomalies or to create a neophallus in female to male transgender patients as part of their gender-confirmation surgery. Reconstructive and functional goals include the ability to void while standing, having erogenous sensation of the tissue, and having the ability to engage in penetrative sexual intercourse. Several techniques for total phalloplasty exist, which include both microsurgical and non-microsurgical approaches. In this review chapter, we outline the most common techniques, provide recent data on patient outcomes, and review operative considerations. This review contains 14 figures, 1 table, and 84 references. Key Words: aphallia, bottom surgery, female-to-male, neophallus, penile reconstruction, perineal reconstruction, phallus, transgender surgery

Thumb Reconstruction using Second—Toe Transfer

HAND ◽  
1983 ◽  
Vol os-15 (1) ◽  
pp. 15-21 ◽  
Author(s):  
P. C. Leung
Keyword(s):  
Thumb Reconstruction ◽  
Toe Transfer ◽  
Second Toe

scholarly journals Thumb Reconstruction with Toe Transfer

2016 ◽  
Vol 02 (02) ◽  
pp. 72-78 ◽  
Author(s):  
Steven Henry ◽  
Fu-Chan Wei
Keyword(s):  
Thumb Reconstruction ◽  
Toe Transfer

Functional Evaluation of a Great Toe Transfer and the Osteoplastic Technique for Thumb Reconstruction in the Same Individual

2003 ◽  
Vol 28 (5) ◽  
pp. 405-408 ◽  
Author(s):  
S. R. SABAPATHY ◽  
H. VENKATRAMANI ◽  
R. R. BHARATHI
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Functional Evaluation ◽  
Great Toe ◽  
Thumb Reconstruction ◽  
Microsurgical Reconstruction ◽  
Functional Activities ◽  
Reconstructive Option ◽  
Toe Transfer

Since the popularization of microvascular toe transfer, there has been a tendency to relegate osteoplastic reconstruction techniques for the thumb to history. A case is presented which shows that a successful and well-planned osteoplastic thumb reconstruction can match microsurgical reconstruction in all functional activities. Cosmetically, the toe transfer is the better reconstructive option but it may cause significant donor site morbidity.

Thumb Reconstruction—Great Toe Transfer

1989 ◽  
Vol 16 (3) ◽  
pp. 475-489 ◽  
Author(s):  
Fredrick A. Valauri ◽  
Harry J. Buncke
Keyword(s):  
Great Toe ◽  
Thumb Reconstruction ◽  
Toe Transfer

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.

A Complex Free Toe Transfer after a Reverse Radial Forearm Flap

1995 ◽  
Vol 20 (1) ◽  
pp. 59-62 ◽  
Author(s):  
R. W. CULP ◽  
W. C. LINEAWEAVER ◽  
M. PARTINGTON ◽  
J. TARAS
Keyword(s):  
Radial Forearm Flap ◽  
Thumb Reconstruction ◽  
Forearm Flap ◽  
Radial Forearm ◽  
Toe Transfer

A case is reported of the difficulties associated with late free toe transfer for thumb reconstruction after an initial reverse radial forearm flap.

Microsurgical Thumb Reconstruction with Toe Transfer

1994 ◽  
Vol 93 (2) ◽  
pp. 352-557 ◽  
Author(s):  
by Fu-Chan Wei ◽  
Hong-Chi Chen ◽  
Chwei-Chin Chuang ◽  
Samuel H. T. Chen
Keyword(s):  
Thumb Reconstruction ◽  
Toe Transfer
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