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Digital reconstruction using the toe flap-- report of 10 cases
The Journal of Hand Surgery
|July 1, 1982
Summary
Free flap reconstruction using a vascular-pedicle wrap-around technique showed good outcomes for hand amputations. However, bone peg resorption and fractures were notable complications in several patients undergoing this reconstructive surgery.
Area of Science:
- Microsurgery
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Reconstruction of severe hand and finger amputations presents significant challenges.
- Free flap techniques offer a solution for restoring function and form.
Purpose of the Study:
- To evaluate the efficacy of the vascular-pedicle wrap-around free flap for reconstructions distal to the metacarpophalangeal joint.
- To assess the expanded use of this technique for toe-to-hand reconstruction in cases of complete finger loss.
Main Methods:
- The vascular-pedicle wrap-around free flap was employed in ten patients.
- Five patients underwent reconstruction for amputations distal to the metacarpophalangeal joint.
- Five patients received a second toe with great toe wrap-around flap for complete finger loss, preserving the thumb.
Main Results:
- All ten patients achieved successful reconstructions with the wrap-around flap technique.
- Significant bone peg resorption was observed in six patients.
- Bone peg fracture occurred in three patients.
Conclusions:
- The vascular-pedicle wrap-around free flap is a viable option for complex hand reconstructions.
- Complications related to bone peg integrity, including resorption and fracture, require careful consideration and potential future management strategies.