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Related Experiment Videos

Microsurgical treatment for bilateral thumb defect: five case reports.

Lei Xu1, Yu-dong Gu, Jian-guang Xu

  • 1Department of Hand Surgery, Hua Shan Hospital, Fudan University, Shanghai, People's Republic of China.

Microsurgery
|January 6, 2004
PubMed
Summary

This study introduces a single-stage surgical technique for bilateral thumb reconstruction using various toe tissue transplants. The procedure demonstrated high success rates, restoring satisfactory appearance and function in reconstructed thumbs.

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Area of Science:

  • Plastic Surgery
  • Microsurgery
  • Orthopedic Surgery

Background:

  • Bilateral thumb defects pose significant reconstructive challenges.
  • Previous methods for thumb reconstruction have limitations in achieving optimal aesthetic and functional outcomes.

Purpose of the Study:

  • To present a novel, efficient, single-stage surgical approach for bilateral thumb reconstruction.
  • To evaluate the efficacy and outcomes of various toe-tissue transplantations in this context.

Main Methods:

  • Single-stage reconstruction utilizing diverse toe-tissue transfers: bilateral second-toe, hallux wrap-around flap, modified hallux wrap-around flap, and combined second toe with index finger flap.
  • Meticulous microsurgical techniques including establishment of double artery supply and venous return systems.

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  • Postoperative circulation monitoring and medical management, followed by a three-stage functional rehabilitation program.

    • Main Results:

    • Eight out of ten transferred toe tissues survived uneventfully, demonstrating successful vascularization.
    • Temporary circulation crises occurred in two transferred tissues but were managed successfully.
    • One-year follow-up revealed satisfactory aesthetic appearance and excellent functional restoration of the reconstructed thumbs.

    Conclusions:

    • The presented single-stage toe-tissue transplantation is an efficient and effective method for bilateral thumb reconstruction.
    • Emphasis on dual vascular supply, modified flap dissection, tendon repair, and systematic rehabilitation is crucial for successful outcomes.
    • The technique offers a promising solution for improving the quality of life for patients with bilateral thumb defects.