Thumb reconstruction by grafting skeletonized amputated phalanges and soft tissue cover – A new technique: A case series

This study reports five cases of crush-avulsion injury to the thumb at different levels presented at our plastic and hand surgery unit between 2005 and 2007. All of the patients were male labors with machine injuries to the thumb with non-replantable amputations. Distal phalanx or proximal phalanx, or both, were used as a free cortical bone graft. The amputated part was skeletonized keeping the periosteum attached to the cortical bone of the phalanx fixing it to the stump and covering it by either local flap like dorsal metacarpal flap or regional flaps like the distally based pedicled radial forearm flap and neurovascular island sensate flap or groin flap. The results were functionally and cosmetically good and follow up X rays showed no osteoporotic resorption after one year

A, B: Injury with crush amputation of the second ray & comminution with bone loss of the thumbs phalanges

C: Phalanx of the index used as a free graft to build the thumb skeleton. D: Soft tissue cover. E, F, G: final result.<p><b>Copyright information:</b></p><p>Taken from "Thumb reconstruction by grafting skeletonized amputated phalanges and soft tissue cover – A new technique: A case series"</p><p>http://www.casesjournal.com/content/1/1/22</p><p>Cases Journal 2008;1():22-22.</p><p>Published online 2 Jul 2008</p><p>PMCID:PMC2518543.</p><p></p

A, B: Avulsion of bone at interphalangeal joint & soft tissue at the metacarpophalangeal joint

C: the bone skeletonized & fixed to the stump & covered with distally based radial forearm fasciocutaneous flap. D, E, F; Final functional & cosmetic result.<p><b>Copyright information:</b></p><p>Taken from "Thumb reconstruction by grafting skeletonized amputated phalanges and soft tissue cover – A new technique: A case series"</p><p>http://www.casesjournal.com/content/1/1/22</p><p>Cases Journal 2008;1():22-22.</p><p>Published online 2 Jul 2008</p><p>PMCID:PMC2518543.</p><p></p