An alternative method to reconstruct grade-3 hypoplastic thumb by hemi-metacarpal transfer
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Updated: Jul 14, 2025
Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
Xiuyue Xu1, Yuzhou Liu1, Le Wang2
1Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, People's Republic of China; NHC Key Laboratory of Hand Reconstruction (Fudan University), Shanghai, People's Republic of China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, People's Republic of China.
Abstract:
We designed a new method using hemi-longitudinal second metacarpal bone to reconstruct grade-3 hypoplastic thumbs. Seven patients were treated in two stages. In the first stage, the second metacarpal was split longitudinally and transferred to reconstruct the first metacarpal. In the second stage, opponensplasty was performed by transferring the FDS tendon. Bone union was achieved in all cases. All patients could oppose to their middle finger at least. They managed to do daily activities such as writing, eating, using smartphones and so on. This is a useful procedure to preserve a 5-digit hand with good function in treating grade-3 hypoplastic thumbs, with no harm to the foot and no need for vascular anastomosis. LEVEL OF EVIDENCE: IV.
