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Related Experiment Videos

The bipolar lengthening technique: a modified partial toe transfer for thumb reconstruction

G Foucher1, M Chabaud

  • 1SOS Main, Strasbourg, France.

Plastic and Reconstructive Surgery
|November 12, 1998
PubMed
Summary

This study introduces bipolar lengthening, a novel thumb reconstruction technique combining first web deepening and distal lengthening. The method shows promising functional recovery and patient satisfaction after proximal phalanx amputation.

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Area of Science:

  • Reconstructive surgery
  • Hand surgery
  • Microsurgery

Background:

  • Thumb amputation through the proximal phalanx presents significant functional challenges.
  • Restoring thumb length, sensation, and strength is crucial for hand function.

Observation:

  • A novel bipolar lengthening technique was applied to seven patients with proximal phalanx amputation.
  • This technique involves first web deepening using an Ostrowski flap and distal lengthening with a free vascularized toe phalanx transfer.

Findings:

  • No technical failures were reported in the seven reviewed cases after a mean 46-month follow-up.
  • Functional outcomes included a mean static 2-point discrimination of 6.3 mm and Semmes-Weinstein testing comparable to the contralateral side in 57% of patients.
  • Grip strength averaged 89% and pinch strength 81% of the contralateral side, with symmetric first web span in 57% of patients.

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Implications:

  • Bipolar lengthening offers a viable solution for thumb reconstruction, creating a shorter thumb that reduces trauma during fist formation.
  • The technique demonstrates good functional recovery in terms of sensation, strength, and cosmetic appearance.
  • This approach may improve the quality of life for individuals with thumb loss due to amputation.