TY - JOUR
T1 - Thumb reconstruction with a wraparound free flap according to the level of amputation
AU - Lee, Kwang Suk
AU - Park, Jong Woong
AU - Chung, Woong Kyo
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2000
Y1 - 2000
N2 - We surgically treated 37 thumbs amputated distal or proximal to the metacarpophalangeal (MCP) joint using a wraparound free flap from the great toe for the reconstruction. We studied the functional results of the procedure according to the level of amputation and the fixation angle of the iliac bone block. The cases were divided into 2 groups: group 1, which comprised 25 cases with the level of amputation distal to the MCP joint, and group 2, which comprised 12 cases with the level of amputation at or proximal to the MCP joint. Opposition of the reconstructed thumb to the other fingers was completely possible in all cases in group 1. In group 2 opposition was completely possible in 6 cases in which the iliac bone block was fixated into the position of 30°flexion and 45°internal rotation; in the remaining 6 cases, in which the graft was fixated into the position of 30°flexion and 30° internal rotation, complete opposition of the reconstructed thumb to the ring and little fingers was not possible. We found that amputation of the thumb proximal to the MCP joint is not an absolute contraindication for the wraparound free flap reconstruction. We recommend fixating the iliac bone block into 30°flexion and 45°internal rotation to obtain better functional outcome in cases with amputation at or proximal to the MCP joint. Copyright (C) 2000 by the American Society for Surgery of the Hand.
AB - We surgically treated 37 thumbs amputated distal or proximal to the metacarpophalangeal (MCP) joint using a wraparound free flap from the great toe for the reconstruction. We studied the functional results of the procedure according to the level of amputation and the fixation angle of the iliac bone block. The cases were divided into 2 groups: group 1, which comprised 25 cases with the level of amputation distal to the MCP joint, and group 2, which comprised 12 cases with the level of amputation at or proximal to the MCP joint. Opposition of the reconstructed thumb to the other fingers was completely possible in all cases in group 1. In group 2 opposition was completely possible in 6 cases in which the iliac bone block was fixated into the position of 30°flexion and 45°internal rotation; in the remaining 6 cases, in which the graft was fixated into the position of 30°flexion and 30° internal rotation, complete opposition of the reconstructed thumb to the ring and little fingers was not possible. We found that amputation of the thumb proximal to the MCP joint is not an absolute contraindication for the wraparound free flap reconstruction. We recommend fixating the iliac bone block into 30°flexion and 45°internal rotation to obtain better functional outcome in cases with amputation at or proximal to the MCP joint. Copyright (C) 2000 by the American Society for Surgery of the Hand.
KW - Thumb reconstruction
KW - Wraparound free flap
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U2 - 10.1053/jhsu.2000.6465
DO - 10.1053/jhsu.2000.6465
M3 - Article
C2 - 10913204
AN - SCOPUS:0033862295
VL - 25
SP - 644
EP - 650
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
SN - 0363-5023
IS - 4
ER -