Evaluation of Different Modalities for Partial Thumb Reconstruction

Document Type : Original Article

Authors

The Department of Plastic Surgery, Faculty of Medicine, Assiut University

Abstract

The thumb considers a part of interesting
significance for hand work. Basically, it is a solitary
unit that is adjusted against every one of the four
fingers. The commitment of the thumb to get a
good grasping is not reliant on great skin sensibility,
in spite of the fact that sensibility must be closing
typical for small object controls [1].
The essential supporter of the flexibility of the
human hand is the opposable thumb, which is basic
for the compelling taking care of and investigation
of fine objects. The broad territory of contact
between the finger pads of the thumb and index
finger is a particularly human trademark [2].
The hand, as the human organ, is in the focal
point of day by day life exercises in callings and
games. In this exceptional position, the hand is
constantly presented to wounds and abuse [3].
The thumb has a part in roughly 40% of hand
capacity; traumatic loss in this manner brings about
significant disability [4].
Traumatic loss of a thumb brings about useful
weakness. Numerous reconstructive modalities
have been depicted to address these losses. Any
technique is of advantage, compared with nothing.
However, each of the techniques offers advantages
and drawbacks and might be more suitable in
certain circumstance [5].
A perfect reconstructed thumb would have
satisfactory length, a sensate, non-tender tip, have
security and be situated to meet alternate digits,
with a sufficient first web space [5].
Aim of the work:
Our objectives in this study are:
• Formulating a strategic approach for distal thumb
reconstruction
• Study of different modalities of distal thumb
reconstruction and evaluation of each modality
regarding its sensation, stability, length, mobility,
Position, and pain-free function.

Main Subjects


Robert W. Beasley: Tendon transfer, thumb reconstruction
& sensory island flaps, Beasley's surgery of the hand,
(19, 20) 319: 369, 2003.
2- Lemon R.N.: Neuralcontrolof dexterity: What has been
achieved? Experimental Brain Research, 128: 6-12, 1999.
3- Voiget C.: Tendon injuries of the hand. Chirurg, 73: 744-
64, 2002.
4- Parvizi D., Koch H. and Friedl H.: Analysis of functional
outcome after posttraumatic thumb reconstruction in
comparison to non reconstructed amputated thumbs at
the proximal phalanx of the thumb ray: A mid-term followup
with special attention to the Manchester-modified M2
DASH questionnaire and effect size of Cohen’s d. J.
Trauma, 72 (2): 33-40, 2012.
5- Graham D.J., H. Venkatramani and S.R. Sabapathy: Current
Reconstruction Options for Traumatic Thumb Loss. J.
Hand Surg. Am., 41 (12): 1159-1169, 2016.
6- Sabapathy S.R., Venkatramani H. and Bharathi R.R.:
Functional evaluation of a great toe transfer and the
osteoplastic technique for thumb reconstruction in the
same individual. J. Hand Surg. Br., 28 (5): 405-408, 2003.
7- Sabapathy S.R., Venkatramani H. and Bhardwaj P.: Reconstruction
of the thumb amputation at the carpometacarpal
joint level by groin flap and second toe transfer.
Injury, 44: 370-5, 2013.
8- Muyldermans T. and Hierner R.: First dorsal metacarpal
artery flap for thumb reconstruction: A retrospective
clinical study. Strategies Trauma Limb Reconstr., 4: 27-
33, 2009.
9- Jung G.J., Kim J.S., Lee D.C., Roh S.Y. and Yang J.W.:
Comparison between Moberg flap and second toe pulp
free flap for coverage of tip amputation of thumb. J.
Korean Soc. Plast. Recontr. Surg., 35 (5): 527-532, 2008