Document Detail


Transfer of a severely damaged digit to reconstruct an amputated thumb.
MedLine Citation:
PMID:  8986666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively reviewed the results of reconstruction of a traumatically amputated thumb with use of an adjacent severely damaged digit in twenty-seven patients (twenty-five male and two female patients). The mean duration of follow-up was nine years (range, two to twenty-one years). The mean age at the time of the reconstruction was thirty-four years (range, thirteen to fifty-six years). Five patients had the reconstruction on the day of the injury and twenty-two, after a mean delay of five months (range, fifteen days to thirteen months). Segments of the index finger were used in twenty-two patients; of the long finger, in four patients; and of the ring finger, in one patient. There were four complications: necrosis of the dorsal skin in one patient, reflex sympathetic dystrophy in one patient, and contracture of the first web space in two patients. Discriminative sensibility was ten millimeters or less, according to the Weber test, in twenty-four thumbs. Cortical integration with reference to the recipient thumb, on stimulation of the pollicized segment, was good in ten patients. Eleven patients could achieve tip-to-tip contact between the thumb and the little finger and twenty-five patients, between the thumb and the most radial finger. The ability to perform activities of daily living was considered good for ten patients, fair for eleven, and poor for six. Only digits with a nail, either present on the transferred segment or as a result of a free vascularized nail transfer, were considered to have a good cosmetic result. Although these results are far from impressive, the reconstruction is a viable alternative for selected patients because it maintains the ability to grasp objects and to oppose the digits.
Authors:
G Foucher; S Rostane; M Chammas; D Smith; Y Allieu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  78     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-29     Completed Date:  1997-01-29     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1889-96     Citation Subset:  AIM; IM    
Affiliation:
SOS Main Strasbourg, France.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adolescent
Adult
Amputation, Traumatic / surgery*
Female
Finger Injuries / surgery*
Fingers / transplantation*
Humans
Male
Middle Aged
Retrospective Studies
Thumb / injuries*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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