Primary Reconstruction for Thumb Amputation

Tsan-Shiun Lin

Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan

^*Correspondance to: Tsan-Shiun Lin 

 PDF  Full Text DOI: 10.25107/2474-1647.1991

Abstract

Purpose: The goals of thumb reconstruction include restoration of its length, strength, position, stability, mobility, sensibility and aesthetics. Compared to other techniques of secondary reconstruction, it emphasizes the choice of primary reconstruction of the injured thumb for the functional and aesthetic benefits.Materials and
Methods: When replantation is not possible, thumb reconstruction is necessary. The technique of sub-dermal pocket is to afford a plenty venous drainage of microsurgical thumb replantation in those cases that do not have a suitable venous plexus for reliable microanastomosis. The composite graft technique associated with the sub-dermal pocket procedure is a feasible resource when it is not possible to perform arterial revascularization of the amputated thumb tip. The employment of the pedicled groin flap gives versatility and reproducibility to reconstruct degloving thumb. One-stage debulking procedure is performed after division of flap. The full thickness skin of the flap is first removed, fatty tissue is excised and the skin finally is regrafted.Results: Based on the collected experience, the described procedures reach satisfactory results concerning length, mobility, sensitivity and skin coverage for a correct work performance and acceptable aesthetic outcomes.Conclusion: The procedures for primary reconstruction of the thumb due to amputation or degloving injury is a reasonable and feasible proposal to achieve satisfactory aesthetic and functional results minimizing additional procedures or complications.

Keywords

Cite the article

Tsan-Shiun Lin. Primary Reconstruction for Thumb Amputation. Clin Surg. 2018; 3: 1991.