TY - JOUR
T1 - Osteoplastic Thumb Reconstruction in the Immediate Setting
T2 - A Case Series
AU - Liu, Yusha
AU - Miller, Erin A.
AU - Wee, Corinne E.
AU - Prsic, Adnan
AU - Eble, Danielle J.
AU - Kao, Dennis S.
N1 - Publisher Copyright:
Copyright © 2022 The Authors.
PY - 2022/6/14
Y1 - 2022/6/14
N2 - Background: Traumatic thumb amputation can have devastating effects on residual hand function. When replantation is not possible, thumb reconstruction is often performed in a delayed manner and may require multiple stages. Furthermore, reconstruction techniques often require microsurgical skills and equipment, which are not readily available at all institutions. This case series illustrates our technique for immediate osteoplastic thumb reconstruction following traumatic amputation. Methods: This is a case series involving all patients who sustained unreplantable thumb amputations and underwent immediate osteoplastic thumb reconstruction with bone autograft and pedicled groin flap by the senior author from September 2016 through August 2018. Results: Five patients underwent immediate osteoplastic thumb reconstruction during the study period. Total operative time for the initial osteoplastic reconstruction averaged 158 minutes (range 96–290 minutes). In addition to flap division surgery, patients underwent an average of 1.2 revision procedures (range 0–2), primarily for debulking and hardware removal. Patients achieved an average gain in length of 3.3cm compared with the maximum anticipated length with revision amputation at the time of injury, and had stable clinical outcomes for a minimum of 12 months. Conclusions: Osteoplastic thumb reconstruction is a useful technique for thumb reconstruction for select patients following traumatic thumb amputation. Advantages of this approach include shorter overall operative times and hospital length of stay, minimal donor site morbidity, and a straightforward, reproducible technique.
AB - Background: Traumatic thumb amputation can have devastating effects on residual hand function. When replantation is not possible, thumb reconstruction is often performed in a delayed manner and may require multiple stages. Furthermore, reconstruction techniques often require microsurgical skills and equipment, which are not readily available at all institutions. This case series illustrates our technique for immediate osteoplastic thumb reconstruction following traumatic amputation. Methods: This is a case series involving all patients who sustained unreplantable thumb amputations and underwent immediate osteoplastic thumb reconstruction with bone autograft and pedicled groin flap by the senior author from September 2016 through August 2018. Results: Five patients underwent immediate osteoplastic thumb reconstruction during the study period. Total operative time for the initial osteoplastic reconstruction averaged 158 minutes (range 96–290 minutes). In addition to flap division surgery, patients underwent an average of 1.2 revision procedures (range 0–2), primarily for debulking and hardware removal. Patients achieved an average gain in length of 3.3cm compared with the maximum anticipated length with revision amputation at the time of injury, and had stable clinical outcomes for a minimum of 12 months. Conclusions: Osteoplastic thumb reconstruction is a useful technique for thumb reconstruction for select patients following traumatic thumb amputation. Advantages of this approach include shorter overall operative times and hospital length of stay, minimal donor site morbidity, and a straightforward, reproducible technique.
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U2 - 10.1097/GOX.0000000000004385
DO - 10.1097/GOX.0000000000004385
M3 - Article
C2 - 35720199
AN - SCOPUS:85148294076
SN - 2169-7574
VL - 10
SP - E4385
JO - Plastic and Reconstructive Surgery - Global Open
JF - Plastic and Reconstructive Surgery - Global Open
IS - 6
M1 - e4385
ER -