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The thumb is integral to the function of the hand, and reconstruction of the thumb in congenital absence and in amputees improves patient quality of life. This chapter provides a comprehensive review of thumb reconstruction. Fundamentals and principles of providing a functional thumb are described, as well as considerations of patient history ...
The thumb is uniquely positioned 60–80 degrees away from the plane of the metacarpal arch. This postural configuration allows the thumb ray to antepose to the fingers, achieving the coordinated function of abduction, opposition and pronation. The function of the CMC joint is paramount to optimal function of the thumb.
nt (IPJ) caused by trauma is usually accompanied by dislocation of the surrounding skin; therefore, it is particularly important to restore the thumb anatomy and skin coverage. Patient concerns: A 41-year-old woman presented with IPJ disfigurement accompanied by a local skin defect caused by machine compression of her right thumb. …
Multiple or thumb indicates multiple-finger or single-finger amputation. Aesthetics improved significantly. Function improved remarkably among cases of thumb or multiple-digit amputation. Complications included fractures of the distal phalanx of big toes during surgery in 2 patients. We fixed them with a Kirchner wire, and the bone healed.
This novel technique facilitates finger and especially thumb preservation without the risk of infection. The Masquelet technique can hereby be safely used for reconstruction of finger injuries and the microsurgical flap coverage can be postponed for the secondary procedure, without compromising the bone regeneration. INTRODUCTION
The goals of thumb reconstruction are to recreate thumb function by restoring these important characteristics of the thumb: length; a padded, sensate tip; stability; position; and mobility. Of these goals, the two most important are restoration of sensation and opposition.
CRITICAL POINTS. The thumb is responsible for 40% to 50% of hand function. The two most important goals of thumb reconstruction are restoration of sensation and opposition. Thumb reconstruction is approached according to the level of loss. Preservation of 2 cm of the proximal phalanx is the minimum effective length of the …
An ideal reconstruction of the thumb would replace "like with like," restoring both function and appearance. Replantation has demonstrated great success, in that it restores the actual lost thumb and …
Osteoplastic thumb reconstruction is a useful technique for thumb reconstruction for select patients following traumatic thumb amputation. Advantages of this approach include shorter overall operative times and hospital length of stay, minimal donor site morbidity, and a straightforward, reproducible technique. Takeaways
Amputated thumbs can be successfully reconstructed with various modifications of the great toe, including whole great toe, trimmed great toe, great-toe wrap-around flaps, and the second toe. Amputated fingers can also be successfully reconstructed with various configurations from lesser toes, achieving results comparable to that of the …
Thumb Reconstruction. 22 years old man Industrial machine accident Stiff fingers and absent thumb Photography and physical examinations are as follow. Volar aspect. Radial aspect. photography. …
Thumb reconstruction aims to restore the cardinal thumb traits and actions including mobility, stability, sensibility, length, and appearance. The level of thumb loss is divided into thirds: distal (tip to interphalangeal [IP] joint), middle (IP joint to metacarpal neck), and proximal (metacarpal neck to carpometacarpal joint). Distal third …
Average follow up at 31.5 months post-op (range of 12-57 months) Average number of therapy sessions 16.8 (range of 10-20 sessions) Pre to post-op grip strength had 50% improvement. Lateral …
In general, thumb reconstruction using the great toe or its variants provides a better functional and aesthetic outcome than use of the lesser toes, although …
3D Reconstruction and of the Thumb and Toe To model the bone and joint of the thumb, patients' injured and healthy hands and feet were scanned using a 64‐row helical CT machine with 0.625‐mm slice thickness. The scan data was output according to the Digital Imaging and Communication in Medicine standard format, and …
Thumb reconstruction is a method that may be considered if replantation is not possible. The technique determined is based on the level of amputation which can either be proximal or distal to the interphalangeal joint. Many techniques have been used previously and succeeded for proximal thumb amputation.
Two patients sustained secondary amputations with further mutilation by the same machine, one was a combined 2nd and 3rd toe transfer for a metacarpal hand and the other was a 2nd toe transfer to replace a thumb. ... Therefore, significant effort has been focused on thumb reconstruction. Numerous techniques have been described, ranging …
a woodworking machine and afterwards reported to the hospital 5 hours post trauma. While giving the first aid, the patient was simultaneously evaluated for any life-threatening injuries according to the latest ... Thumb reconstruction is a method that may be considered if replantation is not possible. The technique
Thumb Joint Reconstruction Surgery involves making an incision over the region of the thumb basilar joint and removing the trapezium (one of the bones in the thumb joint) and cushioning or suspending the thumb joint with the patient's own tissue (flexor carpi radialis tendon) to reconstruct the joint.
The main points for thumb reconstruction are feeling, opposing thumb function and appearance. The first element of thumb opposing function is to recover the length of the thumb. ... Reasons for injury: machine crush injury in two cases; heavy crush injury in two cases; and rotated and avulsed injury in one case. Four patients were male …
In use for more than 40 years, LRTI is the most commonly performed surgery for thumb arthritis. The damaged joint surfaces are removed and replaced with a cushion of tissue …
It is an excellent, pain-relieving surgery that doesn't require fusion of the thumb joint, and therefore preserves the thumb motion.". Hays says that during thumb joint surgery, "the surgeon ...
Brunelli flap is a fasciocutaneous islanded flap demonstrated by Brunelli in 1993. It is a versatile flap for the reconstruction of small to moderate-size defects of the volar and dorsal aspects of the thumb [ 17]. Moschella flap is also known as the reverse first dorsal radial metacarpal flap [ 18].
A newer surgical technique for patients with thumb arthritis involving fiberwire ligament reconstruction halves rehabilitation and immobilization time and significantly …
Thumb reconstruction should aim to restore the cardinal thumb actions: mobility, stability, sensibility, length, and appearance. …
There are a few different types of thumb joint surgery available, but the Arthritis Foundation reports that a procedure called ligament reconstruction and tendon interposition arthroplasty has...
In use for more than 40 years, LRTI is the most commonly performed surgery for thumb arthritis. The damaged joint surfaces are removed and replaced with a cushion of tissue that keeps the bones separated. To accomplish this, surgeons remove all or part of the trapezium bone in the wrist at the base of the thumb.
Introduction Reconstruction of the thumb requires an intact carpometarcarpal joint that not only is stable, but is appropriately functional. Treatment Toe to thumb procedure great toe receives blood supply from …
LRTI stands for ligament reconstruction and tendon interposition. It's a type of surgery for treating arthritis of the thumb, a common type of arthritis in the hand. Joints are formed where two...
According to the Glickel grading system, 51 excellent (80%) (joint stability not significantly different from unoperated thumb, less than 15% MP joint motion loss, no pain, no ADL limitations, and less than 15% loss of pinch strength), 11 good (17%), and 2 fair (3%) outcomes were observed.
Thumb reconstruction is a method that may be considered if replantation is not possible. The technique determined is based on the level of amputation which can either be …