Distal thumb reconstruction with a great toe partial-nail preserving transfer technique

Plastic and Reconstructive Surgery
S H Woo, J H Seul

Abstract

The great toe partial-nail preserving transfer technique is another modification for distal thumb reconstruction in composite defects at or below the interphalangeal joint of the thumb. Noting the size difference of the nail width between the great toe and thumb, the authors dissected only a thumb nail width and skin flap from the great toe, leaving the remainder of the medial skin flap and nail of the great toe at the donor site. A total of 25 cases between 1993 and 1996 were performed using this technique, and the mean follow-up period was more than 12 months. The reconstructed thumb had a better cosmesis with a more natural appearance. At long-term follow-up, the thumb nail width decreased an average of 1.8 mm, but the pulp volume was almost the same as that of the normal contralateral side. The average static 2-point discrimination was less than 9.0 mm. In cases with preserved interphalangeal joint, an average of 48 degrees of range of motion with key-pinch of 80 percent of that of the normal contralateral thumb was achieved. The final appearance of the donor site with partial nail looks like a brachymetatarsia.

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Citations

Aug 2, 2003·British Journal of Plastic Surgery·F SleilatiJ-P Lemerle
May 16, 2000·Plastic and Reconstructive Surgery·I KoshimaT Moriguchi
Aug 12, 2005·Techniques in Hand & Upper Extremity Surgery·Roberto AdaniUmberto Fregni
Apr 28, 2004·Plastic and Reconstructive Surgery·Sang-Hyun WooJung-Hyun Seul
Jul 10, 2012·Burns : Journal of the International Society for Burn Injuries·T KempnýH Klosová
Jun 8, 2006·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Sang Hyun WooJoo-Sung Kim
Jun 18, 1999·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·S H WooJ H Seul
Sep 3, 1999·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·R AdaniM Pinelli
Aug 26, 2017·Plastic and Reconstructive Surgery·Shi-Ming FengCheng-Kun Li
Aug 9, 2017·The Journal of Hand Surgery, European Volume·Roberto Adani, Sang Hyun Woo
May 3, 2006·Plastic and Reconstructive Surgery·Sang-Hyun WooJoo-Sung Kim
Sep 7, 2016·The Journal of Hand Surgery Asian-Pacific Volume·Sang-Hyun WooJung-Wook Paeng

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