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Reconstruction of Fingers Using Skin-Bone Grafts with Microvascular Anastomoses
N M Aleksandrov1,1,2,3, S V Petrov1,1,2,3, D A Kuptsov1,1,2,3
1Leading Researcher, Microsurgical Department, Institute of Traumatology and Orthopedics, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
This study demonstrates the successful use of microvascular anastomoses for skin-bone grafts in hand and finger reconstruction. The technique offers a viable solution for anatomical defects, achieving satisfactory long-term results.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Regenerative Medicine
Background:
- Hand and finger defects pose significant reconstructive challenges.
- Traditional methods may have limitations in restoring both form and function.
- Microvascular transplantation offers a potential solution for complex anatomical defects.
Purpose of the Study:
- To establish a clinical and anatomical rationale for using skin-bone grafts with microvascular anastomoses.
- To evaluate the efficacy of this technique in treating terminal and segmental hand and finger defects.
- To present a modified approach considering individual vascular anatomy.
Main Methods:
- Reconstruction of 25 hands using skin-bone tubular fragments with microvascular anastomoses.
- Utilized second metatarsal bone (n=22) and fibula (n=3) for transplants.
- Employed clinical, radiological, morphological, biomechanical, biophysical, and statistical analyses.
Main Results:
- Successful engraftment in all 25 cases, with minor partial necrosis in two.
- Demonstrated sufficient resistance to resorption of the bone graft.
- Achieved generally good (3 patients) to satisfactory (22 patients) long-term outcomes with mild resorption observed radiologically.
Conclusions:
- Transplantation of skin-bone fragments with microvascular anastomoses is feasible for hand and finger reconstruction.
- The modified technique accommodates donor site vascular variability.
- This approach provides a reliable method for addressing diverse anatomical hand and finger defects.
