Microsurgery Techniques for Patients with Traumatic Thumb Amputation
Introduction. Traumatic amputations of a thumb may happen as a result of severe mechanical injuries with the primary detachment and destruction of tissues, or following deep burns, frostbites or ischemia. In 70 to 80% of cases of disability and the loss of occupational fitness the key causes are tra...
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Bashkir State Medical University
2019-04-01
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| Series: | Креативная хирургия и онкология |
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| Online Access: | https://www.surgonco.ru/jour/article/view/363 |
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| author | M. M. Valeev I. Z. Garapov E. M. Biktasheva |
| author_facet | M. M. Valeev I. Z. Garapov E. M. Biktasheva |
| author_sort | M. M. Valeev |
| collection | DOAJ |
| description | Introduction. Traumatic amputations of a thumb may happen as a result of severe mechanical injuries with the primary detachment and destruction of tissues, or following deep burns, frostbites or ischemia. In 70 to 80% of cases of disability and the loss of occupational fitness the key causes are traumatic digit and hand amputations. In 50% of cases the loss of ability to work is due to an amputation of a thumb. This makes the issue of thumb reconstruction a priority in surgery of the hand.Materials and methods. This paper presents our experience in the reconstruction of the functional abilities of the hand in 48 patients with traumatic amputations of a thumb. This was performed with the use of reconstructive plastic microsurgery techniques, namely the free transplantation of a second toe onto the hand. All the patients had a thumb stump at the level of the distal part of the metacarpal bone or the proximal part of the proximal phalanx.Results and discussion. A positive outcome was achieved in 45 out of the 48 patients treated. Autograft necrosis occurred in three cases. For these patients the thumb reconstruction was performed with the use of other, less functional methods. The functional condition of the hand manifested an improvement according to the electromyography data obtained at the maximum tonic tension of the thenar eminence muscles, flexor and extensor muscles of the reconstructed digit. In all the cases the hand strength increased by 40 to 90% after the reconstructive surgery; the authors attribute this to the recovery of the key handgrip abilities. According to Doppler ultrasonography data the blood flow velocity and the level of blood filling increased in the hand treated.Conclusion. The reconstruction of functional abilities of the hand with traumatic thumb amputation must be carried out taking into account the available methods of surgical correction and which one of these would be optimal, the evaluation of the patient’s mental status and his or her drive for the fastest possible recovery of the shape and function of the hand. The free autograft of a second toe in place of the lost thumb with microsurgical vascular anastomoses makes it possible to restore most completely the aesthetic and functional abilities of the hand in the shortest possible timeframe. |
| format | Article |
| id | doaj-art-bfbdca9efe47441b941350edd8e3c3bc |
| institution | DOAJ |
| issn | 2076-3093 2307-0501 |
| language | English |
| publishDate | 2019-04-01 |
| publisher | Bashkir State Medical University |
| record_format | Article |
| series | Креативная хирургия и онкология |
| spelling | doaj-art-bfbdca9efe47441b941350edd8e3c3bc2025-08-20T03:19:20ZengBashkir State Medical UniversityКреативная хирургия и онкология2076-30932307-05012019-04-0191444910.24060/2076-3093-2019-9-1-44-49312Microsurgery Techniques for Patients with Traumatic Thumb AmputationM. M. Valeev0I. Z. Garapov1E. M. Biktasheva2Bashkir State Medical UniversityBashkir State Medical UniversityBashkir State Medical UniversityIntroduction. Traumatic amputations of a thumb may happen as a result of severe mechanical injuries with the primary detachment and destruction of tissues, or following deep burns, frostbites or ischemia. In 70 to 80% of cases of disability and the loss of occupational fitness the key causes are traumatic digit and hand amputations. In 50% of cases the loss of ability to work is due to an amputation of a thumb. This makes the issue of thumb reconstruction a priority in surgery of the hand.Materials and methods. This paper presents our experience in the reconstruction of the functional abilities of the hand in 48 patients with traumatic amputations of a thumb. This was performed with the use of reconstructive plastic microsurgery techniques, namely the free transplantation of a second toe onto the hand. All the patients had a thumb stump at the level of the distal part of the metacarpal bone or the proximal part of the proximal phalanx.Results and discussion. A positive outcome was achieved in 45 out of the 48 patients treated. Autograft necrosis occurred in three cases. For these patients the thumb reconstruction was performed with the use of other, less functional methods. The functional condition of the hand manifested an improvement according to the electromyography data obtained at the maximum tonic tension of the thenar eminence muscles, flexor and extensor muscles of the reconstructed digit. In all the cases the hand strength increased by 40 to 90% after the reconstructive surgery; the authors attribute this to the recovery of the key handgrip abilities. According to Doppler ultrasonography data the blood flow velocity and the level of blood filling increased in the hand treated.Conclusion. The reconstruction of functional abilities of the hand with traumatic thumb amputation must be carried out taking into account the available methods of surgical correction and which one of these would be optimal, the evaluation of the patient’s mental status and his or her drive for the fastest possible recovery of the shape and function of the hand. The free autograft of a second toe in place of the lost thumb with microsurgical vascular anastomoses makes it possible to restore most completely the aesthetic and functional abilities of the hand in the shortest possible timeframe.https://www.surgonco.ru/jour/article/view/363reconstructive surgical procedurestraumatic amputationhandthumbmicrosurgerysurgical anastomosisautograft |
| spellingShingle | M. M. Valeev I. Z. Garapov E. M. Biktasheva Microsurgery Techniques for Patients with Traumatic Thumb Amputation Креативная хирургия и онкология reconstructive surgical procedures traumatic amputation hand thumb microsurgery surgical anastomosis autograft |
| title | Microsurgery Techniques for Patients with Traumatic Thumb Amputation |
| title_full | Microsurgery Techniques for Patients with Traumatic Thumb Amputation |
| title_fullStr | Microsurgery Techniques for Patients with Traumatic Thumb Amputation |
| title_full_unstemmed | Microsurgery Techniques for Patients with Traumatic Thumb Amputation |
| title_short | Microsurgery Techniques for Patients with Traumatic Thumb Amputation |
| title_sort | microsurgery techniques for patients with traumatic thumb amputation |
| topic | reconstructive surgical procedures traumatic amputation hand thumb microsurgery surgical anastomosis autograft |
| url | https://www.surgonco.ru/jour/article/view/363 |
| work_keys_str_mv | AT mmvaleev microsurgerytechniquesforpatientswithtraumaticthumbamputation AT izgarapov microsurgerytechniquesforpatientswithtraumaticthumbamputation AT embiktasheva microsurgerytechniquesforpatientswithtraumaticthumbamputation |