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The aesthetic mini wrap-around technique for thumb reconstruction.
Roberto Adani1, Ignazio Marcoccio, Luigi Tarallo
1Department of Orthopaedic Surgery, University of Modena and Reggio Emilia, Modena, Italy. adani.roberto@unimo.it
Techniques in Hand & Upper Extremity Surgery
|August 12, 2005
Summary
The great toe mini wrap-around flap effectively reconstructs thumb defects, offering good sensation and cosmetic results with minimal donor site issues. This technique is ideal for selected patients needing thumb reconstruction.
Area of Science:
- Plastic Surgery
- Hand Surgery
- Microsurgery
Background:
- Thumb defects distal to the interphalangeal joint present significant functional and aesthetic challenges.
- Reconstruction of thumb defects requires techniques that restore both form and function.
Purpose of the Study:
- To evaluate the efficacy of the great toe mini wrap-around flap for reconstructing thumb defects.
- To assess functional and aesthetic outcomes, including sensory recovery and patient satisfaction.
Main Methods:
- Retrospective analysis of 16 cases of thumb reconstruction using a great toe mini wrap-around flap.
- Flap included the nail and distal phalanx of the great toe.
- Outcomes assessed by graft survival, 2-point discrimination, cold intolerance, and patient-reported cosmesis.
Main Results:
- Fifteen of 16 flaps (93.75%) survived.
- Good sensory recovery with an average 2-point discrimination of 10 mm (range 5-15 mm).
- No reported cold intolerance; high patient satisfaction with cosmetic results and minimal donor site morbidity.
Conclusions:
- The great toe mini wrap-around flap is a reliable and effective method for thumb reconstruction distal to the interphalangeal joint.
- The technique provides excellent functional and aesthetic outcomes with low morbidity.
- Patient selection based on gender, job, and age is crucial for optimal results.