A technique for the non-microsurgical reconstruction of thumb tip amputations

Abstract

This article aims to present a technique for thumb tip amputations using a homodigital soft-tissue/periosteum flap and a portion of the amputated digit. Eight patients (aged 21-53 years) with avulsion thumb tip amputations were reviewed. We report a new technique in which a bone and nailbed composite graft was taken from the amputated portion of the thumb and a dorsoulnar flap combined with periosteum was harvested from the first metacarpal and designed to cover the volar bone. Patients were evaluated 6 months after surgery for functional and cosmetic outcomes. The radiographic evaluation showed bone healing in all of the patients 5 weeks postoperatively. With regard to pulp reconstruction, there was good recovery of static two-point discrimination. For both the reconstructed area and the donor site, the final results were good in terms of reliability and coverage as well as from a cosmetic perspective. This technique was found to be safe and effective. It is a good option for the non-microsurgical reconstruction of crushed and avulsed amputations of the distal thumb.