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Published on: April 12, 2019
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[Thumb reconstruction with skin and soft tissue expansion]
Xiaowei Zhao1, Wei Wang, Yun Han
1Department of Hand Surgery, the Songgang People's Hoospital of Shenzhen, Shenzhen Guangdong, P R China. xiaoweizhao2008@163.com
Summary
This study presents a new, reliable skin soft tissue expansion technique for severe thumb reconstruction. The method effectively restores thumb function and appearance in patients with grades V and VI defects.
Area of Science:
- Orthopedic Surgery
- Plastic Surgery
- Regenerative Medicine
Background:
- Thumb defects, particularly grades V and VI, present significant reconstructive challenges.
- Traditional methods may have limitations in restoring both form and function.
Observation:
- Eight patients with severe thumb defects (grades V and VI) underwent reconstruction using skin soft tissue expansion.
- Expanders were placed subcutaneously and gradually inflated with saline to create adequate tissue flaps.
- Iliac autografts were used for skeletal reconstruction, covered by the expanded flaps.
Findings:
- All reconstructed thumbs demonstrated successful viability and durable outcomes post-operatively.
- Good sensation, appearance, and functional recovery, including opposition and fine motor skills (2-point discrimination < 5 mm), were observed.
- Bone union was achieved within 3-4 months, with better functional results noted in grade V defects compared to grade VI.
Implications:
- Skin soft tissue expansion offers a convenient and reliable alternative for complex thumb reconstruction.
- This technique holds promise for improving functional and aesthetic outcomes in patients with severe thumb injuries.
- Further research can explore long-term functional preservation and patient-reported outcomes.
