Purpose: This article aims to present a technique for thumb tip amputations using a homodigital soft-tissue/periosteum flap and a portion of the amputated digit.
Methods: Eight patients (aged 21-53 years) with avulsion thumb tip amputations were reviewed. We report a new technique in which a bone and nailbed composite graft was taken from the amputated portion of the thumb and a dorsoulnar flap combined with periosteum was harvested from the first metacarpal and designed to cover the volar bone. Patients were evaluated 6 months after surgery for functional and cosmetic outcomes.
Results: The radiographic evaluation showed bone healing in all of the patients 5 weeks post-operatively. With regard to pulp reconstruction, there was good recovery of static two-point discrimination. For both the reconstructed area and the donor site, the final results were good in terms of reliability and coverage as well as from a cosmetic perspective.
Conclusions: This technique was found to be safe and effective. It is a good option for the non-microsurgical reconstruction of crushed and avulsed amputations of the distal thumb. Crown Copyright (C) 2013 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.
[1]Shanghai Jiao Tong Univ, Dept Plast & Reconstruct Surg, Peoples Hosp 9, Sch Med, Shanghai 200030, Peoples R China.
[2]Jilin Univ, China Japan Union Hosp, Dept Hand Surg, Changchun 130031, Peoples R China.
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