Osteoplastic Reconstruction for Post Traumatic Thumb Amputations Around Metacarpophalangeal Joint
Introduction: Loss of a thumb due to trauma warrants replantation which is the best method of reconstruction. When replantation is not possible, thumb reconstruction is the procedure of choice. The level of thumb amputation guides the type of reconstruction. There are five goals for reconstructi...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/6404/14334_CE(RA1)_F(T)_PF1(PAK)_PFA(NC_AK)_PF2(PAG).pdf |
| Summary: | Introduction: Loss of a thumb due to trauma warrants replantation
which is the best method of reconstruction. When replantation is
not possible, thumb reconstruction is the procedure of choice.
The level of thumb amputation guides the type of reconstruction.
There are five goals for reconstructing a thumb: restoration of (1)
functional length (2) stability (3) mobility (especially opposition) (4)
sensibility and (5) aesthetic appearance.
Aim: This study was conducted to evaluate the functional outcome
of two main techniques of osteoplastic thumb reconstruction (1)
Osteocutaneous distally based radial forearm flap (2) Groin flap
with iliac crest bone graft.
Materials and Methods: Total 13 patients underwent osteoplastic
reconstruction in the duration from August 2012 to December
2014. Thumb reconstruction was done using distally based
radial forearm osteocutaneous flap in 7 patients and two staged
reconstruction by groin flap with iliac crest bone graft in 6 patients.
Postoperatively results were assessed in terms of range of motion,
hand grip, functional recovery, donor site morbidity and patient
satisfaction.
Results: All reconstructive thumbs were functionally acceptable.
Cosmetically, donor site morbidity was an issue for 2 patients
with radial forearm flap and 1 patient with groin flap. Suture
line dehiscence and plate exposure required intervention in
local anaesthesia in one patient with radial forearm flap. After
reconstruction absence of pain, temperature and touch sensation
were observed.
Conclusion: We suggest that osteoplastic reconstruction is
a reliable procedure in terms of stability, length, strength and
opposability if basal joint is intact. Most of the patients in this study
were manual labourers who went back to previous occupation
and were able to use their thumb for daily activities for earning
livelihood. |
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| ISSN: | 2249-782X 0973-709X |