Abstract
Defects of the thumb negatively impact physical and mental health, lead to depression, inferiority complex and hopelessness in the future. The aim of the study was to explore long-term results of thumb reconstruction using autologous transplantation of the second toe with microvascular anastomoses. Material and methods Second toe transplantation for thumb reconstruction was performed for 54 patients. There were 48 male and 6 female patients aged from 12 to 55 years. When analyzing the long-term results of surgical treatment of patients. The anatomy and functionality of the repaired finger was evaluated at a long term measuring the range of motion in the joints, muscle strength of the hand and major types of hand grips. Results The autograft completely healed with opposition of the reconstructed thumb and the rest fingers restored in 51 patients. The autograft failed in three cases treated with less functional methods. Conclusion Microsurgical reconstruction technologies used for a lost thumb facilitated rapid recovery of the finger and significantly improved functions of the injured hand as an entity. Free second toe transplantation using microvascular anastomoses for the thumb reconstruction allowed the patient regain basic gripping functions and improve cosmesis of the injured hand.
Highlights
Traumatic finger amputation due to necrosis of soft tissues lead to persistent impairment of the hand function in 70–80 % of the cases
Absence of the thumb is the reason for a 50 % decrease in working capacity, and significant effort has been focused on thumb reconstruction [1–12]
The autograft failed to survive in three patients who were treated with less functional methods to improve the thumb function
Summary
Traumatic finger amputation due to necrosis of soft tissues lead to persistent impairment of the hand function in 70–80 % of the cases. The reconstructive thumb must have an aesthetic appearance, sufficient length and full sensitivity and provide hand grips. The opposability of the human thumb is its unique ability to oppose the other four fingers performing subtle kinematic movements. The reconstruction technique of the thumb to maximally regain aesthetic attractiveness and functionality of the injured hand would depend on the length of the stump and the condition of the tenar muscles [2, 3, 7, 9, 13–23]. Thumb reconstruction is essential for younger patients who lose the ability to perform professional, household and social duties with traumatic thumb loss and that urges surgeons look for optimal treatments to solve the problem [24–39]
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