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Thumb Reconstruction Quiz 5 14/6/1387
22 years old man Industrial machine accident Stiff fingers and absent thumb Photography and physical examinations are as follow
photography Volar aspectRadial aspect Dorsal aspect
Normal 1 st CMC ROM Amputation from mid metacarp of thumb Split thickness skin graft Near complete stiff index Amputated and stiff middle finger Pulp-to-palm distance 4cm. In ring and little finger
Soft tissue of the dorsal aspect is near normal
MP joint of the index and the middle finger are fixed in hyper extension
Radiography reveals the same findings ◦Normal 1 st CMC ◦1 st metacrpal amputation from mid-shaft ◦Destroyed 2 nd and 3 rd MP joint ◦Middle finger amputation from middle phalanx
How to reconstruct the thumb? References ◦Green’s hand surgery ◦Masquallet Flaps
Thumb deficiency Traumatic
Thumb The most important part of the hand Necessary for pinch and powerful grip
Traumatic Thumb Deficiency Reconstruction 1-Distal third 2-Middle third 3-Proximal third
1/phalangization Web deepening ◦Simple ◦appearance
Dorsal interosseus flap
3/Microvascular tissue transfers Great toe transfer 2 nd toe transfer Wraparound great toe Free composite transfer
Thumb Reconstruction with Foucher Flap Technique
Flap in new site
Donor site coverage
Sensory reconstruction Neurovascular island flap
Lateral cutaneus of forearm
Index pollicization on the thumb stump
This technique needs a functional digital NV How about 1 st dorsal intermetacarpal a. flap
photography Volar aspectLateral view Dorsal aspect
Summer Anatomy Lab July 25, 2013 Jennifer Klok
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ANTERIOR ASPECT OF THE FOREARM
Kinesiology PED 2440.
Injuries to Hand, Wrist and Forearm - Mr. Brewer.
Flaps in the Hand Aims The treatment objectives in hand reconstruction are to: close the wound maximize sensory return preserve length maintain joint.
Image Evaluation Chapter 3
Hand OITE A 25-year-old woman sustains an injury to the tip of her ring finger in a meat slicing machine. Examination reveals volar tissue loss.
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Department of Hand & Reconstructive Microsurgery TENDON TRANSFERS FOR THE HAND National Congress of Indonesian Surgery for Surgery of the Hand (HIPITA)
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PALM OF THE HAND Dr. Ahmed Fathalla Ibrahim.
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