Single stage thumb reconstruction is possible with a new composite skin bone flap from the forearm. The primary vascularisation of skin and bone avoids the disadvantages of the conventional multi-staged procedures such as neurovascular insufficiency, infection and bone absorption. It does not require a surgical team with microsurgical expertise. The best indication is the reconstruction in the subtotal thumb amputation.
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References
1.
BAGOZZI, IC (1960). Evolution De l’Autogreffe Osseuse Dans La Reconstruction Plastique Des Doigts. Annales de Chirurgie Plastique, 5, 111-114.
2.
BROADBENT, TR, and RM WOOLF (1960). Thumb Reconstruction With Contiguous Skin-Bone Pedicle Graft. A Case Report. Plastic and Reconstructive Surgery, 26, 494-499.
3.
BUCK-GRAMCKO, D (1971). Pollicisation of the Index Finger. Methods and Results in Aplasia and Hypoplasia of the Thumb. The Journal of Bone and Joint Surgery, 53A, 1605-1617.
4.
BUNCKE, HJ, Jr, DH McLEAN, PT GEORGE, BJ CREECH, NL CHATER, and GW COMMONS (1973). Thumb Replacement: Great Toe Transplantation by Microvascular Anastomosis. British Journal of Plastic Surgery, 26, 194-201.
5.
COBBETT, JR (1969). Free Digital Transfer. Report of a Case of Transfer of a Great Toe to Replace an Amputated Thumb. The Journal of bone and Joint Surgery, 51B, 677-679.
6.
DOI, K, S HATTORI, S KAWAI, S NAKAMURA, H KOTANI, A MATSUOKA, and K SUNAGO (1981). New procedure on making a thumb-one-stage reconstruction with free neurovascular flap and iliac bone graft. The Journal of Hand Surgery, 6, 346-350.
7.
DOLICH, BH, KJ OLSHANSKY, and AH BABAR (1978). Use of a Cross-Forearm Neurocutaneous Flap to Provide Sensation and Coverage in Hand Reconstrruction. Plastic and Reconstructive Surgery, 62, 550-558.
8.
FOUCHER, G, M MERLE, M MANEAUD, and J MICHON (1980). Microsurgical Free Partial Toe Transfer in Hand Reconstruction. A Report of 12 Cases. Plastic and Reconstructive Surgery, 65, 616-627.
9.
FOUCHER, G, F VAN GENECHTEN, M MERLE, and J MICHON (1984). A compound radial artery forearm flap in hand surgery: An original modification of the Chinese forearm flap. British Journal of Plastic Surgery, 37, 139-148.
10.
GELLIS, MR, and R POOL (1977). Two-point Discrimination Distances in The Normal Hand and Forearm. Application to Various Methods of Finger-Tip Reconstruction. Plastic and Reconstructive Surgery, 59, 57-63.
11.
GOSSET, J (1949). La pollicisation de l’index (technique chirurgicale). Journal de Chirurgie, 65, 403.
12.
GUEULLETTE, R (1930). Ëtude critique des procédés de restauration du pouce. Journal de Chirurgie, 36, 1-23.
13.
GUERMONPREZ, F (1887). Notes sur quelques résections et restaurations du pouce. In . Paris: P. Asselin.
14.
HILGENFELDT, O (1950). Operativer Daumenersatz und Beseitigung von Griefstörungen bei Fingerverlusten. Stuttgart: Ferdinand Enke Verlag.
15.
HUGUIER, PC (1874). Remplacement du pouce par son métacarpien, par l'aggrandissement du premier espace interosseux. Archives Génerates de Médecine, 23, 78-82.
16.
LITTLER, JW (1953). The Neurovascular Pedicle Method of Digital Transposition for Reconstruction of the Thumb. Plastic and Reconstructive Surgery, 12, 303-319.
17.
MATEV, IB (1970). Reconstruction of the Thumb through Gradual Elongation of the Thumb Metacarpal. The Journal of Bone and Joint Surgery, 52A, 1058.
18.
McGREGOR, IA, and C SIMONETTA (1964). Reconstruction of the Thumb by Composite Bone-Skin Flap. British Journal of Plastic Surgery, 17, 37-48.
19.
MORGAN, LR, and F STEIN (1972). Method for a Rapid and Good Thumb Reconstruction. Plastic and Reconstructive Surgery, 50, 131-48.
20.
MORRISON, WA, BMcC O’BRIEN, and AM MacLEOD (1980). Thumb reconstruction with a free neurovascular wrap-around flap from the big toe. The Journal of Hand Surgery, 5, 575-583.
21.
NICOLADONI, C (1897). Daumenplastik. Wiener Klinische Wochenschrift, 10, 663.
22.
NICOIADINI, C (1900). Daumenplastik und organischer Ersatz der Fingerspitze. (Anticheiroplastik und Daktyloplastik) Archiv für Klinische Chirurgie, 61, 606-628.
23.
NOESSKE, K (1920). Uber Ersatz samt Metakarpus verlorenen Daumens durch operative Umstellung des Zeigefingers (mit Lichtbildern). Münchener Medizinische Wochenschrift, 67, 465-466.
24.
OHMORI, K, J SEKIGUCHI, and S OHMORI (1979). Total Rhinoplasty with a Free Osteo-cutaneous Flap. Plastic and Reconstructive Surgery, 63, 387-394.
25.
VERDAN, CL (1968). The Reconstruction of the Thumb. Surgical Clinics of North America, 48, 1033-1061.
