Abstract
Many methods for the repair of degloving injuries of the thumb have been reported, but none are entirely satisfactory. Herein, we report a method in which the injury is divided into the dorsal and palmar area for repair. A great toenail flap is used to repair the dorsal injury to restore the nail defect, and a dorsalis pedis flap is used to repair the palmar injury. The described technique provides good restoration of morphology and aesthetic outcome, good functional and sensory recovery, and is associated with minimal donor-site morbidity.
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References
Davis Sears E, Chung KC (2011) Replantation of finger avulsion injuries: a systematic review of survival and functional outcomes. J Hand Surg Am 36:686–694
Wang L, Fu J, Li M, Han D, Yang L (2013) Repair of hand defects by transfer of free tissue flaps from toes. Arch Orthop Trauma Surg 133:141–146
Trevisan C, Mattavelli M, Monteleone M, Marinoni EC (2008) Pulp thumb defect reconstruction using a twin neurovascular island flaps: a case report. Arch Orthop Trauma Surg 128:195–198
Oh SJ, Koh SH, Chung CH (2010) Twin digital and in-step neurovascularised free flaps for reconstruction of the degloved mutilated hands. J Plast Reconstr Aesthet Surg 63:1853–1859
Noaman HH (2012) Salvage of complete degloved digits with reversed vascularized pedicled forearm flap: a new technique. J Hand Surg 37A:832–836
Adani R, Corain M, Tarallo L, Fiacchi F (2013) Alternative method for thumb reconstruction. Combination of 2 techniques: metacarpal lengthening and mini wraparound transfer. J Hand Surg 38A:1006–1011
Chi Z, Gao W, Yan H, Li Z, Chen X, Zhang F (2012) Reconstruction of totally degloved fingers with a spiraled parallelogram medial arm free flap. J Hand Surg 37A:1042–1050
Zhang X, Shao X, Ren C, Zhang Z, Wen S, Sun J (2011) Reconstruction of thumb pulp defects using a modified kite flap. J Hand Surg 36A:1597–1603
Zhang X, Yang L, Shao X, Wen S, Zhu H, Zhang Z (2011) Use of a bilobed second dorsal metacarpal artery-based island flap for thumb replantation. J Hand Surg 36A:908–1006
Sauerbier M, Unglaub F (2010) Perforator flaps in the upper extremity. Clin Plastic Surg 37:667–676
Ulrich D, Fuchs P, Bozkurt A, Pallua N (2010) Free serratus anterior fascia flap for reconstruction of hand and finger defects. Arch Orthop Trauma Surg 130:217–222
Adani R, Marcoccio I, Tarallo L, Fregni U (2005) The aesthetic mini wrap-around technique for thumb reconstruction. Tech Hand Up Extrem Surg 9:42–46
Takeuchi M, Sakurai H, Sasaki K, Nozaki M (2000) Treatment of finger avulsion injuries with innervated arterialized venous flaps. Plast Reconstr Surg 106:881–885
Rui Y, Mi J, Shi H, Zhang Z, Yan H (2010) Free great toe wrap-around flap combined with second toe medial flap for reconstruction of completely degloved fingers. Microsurgery 30:449–456
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Ju, Jh., Hou, Rx. Repair of a degloving injury of the thumb with a combined dorsal great toenail flap and dorsalis pedis flap: a case report. Arch Orthop Trauma Surg 133, 1455–1458 (2013). https://doi.org/10.1007/s00402-013-1807-5
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DOI: https://doi.org/10.1007/s00402-013-1807-5