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Reconstruction of the burned thumb
L C Kurtzman1, P J Stern, K P Yakuboff
1Division of Plastic, Reconstructive and Hand Surgery, University of Cincinnati College of Medicine, OH 45267.
Hand Clinics
|February 1, 1992
Summary
Reconstructing thumb contractures involves soft-tissue release and coverage. Thumb length restoration for prehension and opposition uses techniques like phalangealization or toe-to-thumb transfer.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Reconstructive surgery
Background:
- The thumb is crucial for hand function, contributing 40-50%.
- Soft-tissue contractures significantly impair thumb function and aesthetics.
- Restoring thumb length is vital for prehension and opposition.
Purpose of the Study:
- To review methods for reconstructing thumb soft-tissue contractures.
- To outline techniques for restoring thumb length and function.
- To discuss the indications for various reconstructive approaches.
Main Methods:
- Review of surgical techniques for soft-tissue contracture release.
- Analysis of coverage options including skin grafts and flaps (local, regional, distant, free).
- Evaluation of methods for thumb length restoration: phalangealization, pollicization, toe-to-thumb transfer.
Main Results:
- Soft-tissue contractures are managed with release and various flap or graft coverage.
- Thumb length can be effectively restored using phalangealization, pollicization, or toe-to-thumb transfer.
- Metacarpal distraction-lengthening and osteoplastic reconstruction are less commonly indicated.
Conclusions:
- Effective reconstruction of thumb soft-tissue contractures is achievable with current surgical methods.
- Restoration of thumb length is a key component in improving hand function after contracture release.
- The choice of technique depends on the specific clinical scenario and desired functional outcome.