Thumb Reconstruction with a Free Neurovascular Wrap
10.4055/jkoa.1984.19.6.1109
- Author:
Soo Bong HAHN
;
Jung Sun KIM
- Publication Type:Case Report
- Keywords:
Thumb reconstruction;
Free neurovascular wrap-around flap
- MeSH:
Arteries;
Discrimination (Psychology);
Follow-Up Studies;
Foot;
Hallux;
Joints;
Methods;
Peroneal Nerve;
Sensation;
Thumb;
Toes;
Transplants
- From:The Journal of the Korean Orthopaedic Association
1984;19(6):1109-1116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This article introduces a new method of thumb reconstruction with the use of an iliac bone graft and a free neurovascular wrap-around flap from the big toe, previously reported by Morrison et al. in 1980. Using this method it is possible to reconstruct a thumb similar to the missing part without total sacrifice of the toe. There is no mobile portion in the reconstructed thumb and motion is provided only by intact joint of traumatized thumb. In thumb reconstruction, it is possible to preserve the nail and its pulp, thus preventing swivelling of the nail and loss of pulp sensation as well as ensuring continued nail growth. This is achieved by free tissue transfer from the 1st web space of the foot, innervated by the deep peroneal nerve and supplied by the dorsalis pedis artery with relatively large diameter. Three cases of thumb reconstruction were performed with this method. Follow up was done for an average of 11.3 months; the rate of viability was 100% with excellent appearance; the 2-point discrimination averaged 8.3 mm.
