A simple approach to thumb amputation reconstruction at metacarpal base with toe transfer, two case reports

International Journal of Surgery Case Reports
Viet Tan NguyenViet Tien Nguyen

Abstract

Reconstruction for thumb amputation at the metacarpal base by toe transfer is challenging. To restore a thumb with normal or near-normal length, the reconstruction plan usually involves a complicated and challenging process either in two stages (stage 1: resolving soft tissue and bone defect; stage 2: toe transfer) or a single stage by using two free flaps (one free soft tissue flap and one toe flap). However, is it necessary to restore the full length of the thumb for functional and aesthetic achievement? Two male patients (21 and 22 years old) had a thumb amputation at the metacarpal base. We accepted the shortened metacarpal length and performed reconstruction in one stage by trimmed great toe flap, at the level of the metatarsophalangeal joint. The first phalanx of toe flap was fused with the first metacarpal base. On long-term follow-up, both patients were able to return to daily activities, work and had a good cosmesis. With our reconstruction technique, two reconstructed thumbs were functionally similar to a thumb amputation group 1 of Campbell-Reid. Using trimmed great toe flap, the tip of our reconstructed thumbs looks like that of a normal thumb. Both patients were satisfied. Accepting length shortening, the reconstru...Continue Reading

References

Aug 1, 1960·The Journal of Bone and Joint Surgery. British Volume·D A REID
Mar 10, 2006·Plastic and Reconstructive Surgery·Osamu IshidaMitsuo Ochi
May 5, 2007·Hand Clinics·Gregory M BunckeCharles K Lee
Aug 9, 2017·The Journal of Hand Surgery, European Volume·Roberto Adani, Sang Hyun Woo
Oct 21, 2018·International Journal of Surgery·Riaz A AghaUNKNOWN SCARE Group

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Citations

Dec 2, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Van Doan LeViet Tan Nguyen

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Methods Mentioned

BETA
amputation

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