Soft Tissue Reconstruction

Abstract

For the proper thumb function, the thumb should have appropriate length with pliable and sensate soft tissue. The external appearance of the thumb is also important due to its noticeable position. Thumb defect is classified into four groups by Lister: (1) acceptable length but poor soft tissue coverage, (2) subtotal amputation with uncertainty in length, (3) total amputation with basal joint, and (4) total amputation without basal joint. This chapter will discuss about reconstruction options of soft tissue defects of the thumb within the Group I defect. Soft tissue defects on the thumb can be caused by machinery compression, burn, knife injury, and inflammation. The goals of soft tissue reconstruction of the thumb include length, sensory, and appearance. Various options such as local flaps, distant flaps, and free flaps are available. The location and size of the defect are key determinants for the choice of the flap. Other considerable factors are patient age, hand dominance, occupation, and surgeon’s familiarity.