Thumb Tip Reconstruction with Subcutaneous Pocket Graft: 2 Cases Report

Lee,  Young Keun; Moon,  Young Jae; Lee,  Jun Mo

doi:2011.20.2.126

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Arch Hand Microsurg > Volume 20(2); 2011 > Article

Case Report

Journal of the Korean Society for Surgery of the Hand 2011;20(2):126-131.
Published online November 30, 2011.
DOI: https://doi.org/10.12790/jkssh.2011.20.2.126

Thumb Tip Reconstruction with Subcutaneous Pocket Graft: 2 Cases Report

Young-Keun Lee, M.D.*, Young-Jae Moon, M.D. and Jun-Mo Lee, M.D.

¹Department of Orthopedic Surgery, Dason Orthopedic Clinic, Jeonju, Korea.
²Department of Orthopedic Surgery, Chonbuk National University Medical School, and Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea. junmolee@jbnu.ac.kr

피하 주머니 이식술을 이용한 수부 무지 첨부 재건술 - 2예 보고 -

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²

Abstract

Purpose: The subcutaneous pocket graft of the thumb tip amputation across or proximal to the lunula is chosen in case of impossible microvascular anastomosis and in patient who strongly desired to preserve the thumb tip after failed replantation.
Materials and Methods: Two patients who underwent a subcutaneous pocket graft for a thumb tip reconstruction between August 2008 and November 2009 were reviewed retrospectively. They were all males with a mean age at the time of surgery of 48 years and had sustained complete thumb tip amputations across or proximal to the lunula. In one case, the microsurgical replantation was not feasible and the other one revealed arterial insufficiency at the 7th day after microsurgical replantation.
Results: Authors had experienced 2 cases of flaps which survived completely. The results of sensibility was good, the range of motion at interphalangeal joint and tip to tip pinch was acceptable and color mismatch and loss of thumb finger nail was unacceptable after more than 1 year follow up with conventional successful thumb tip replantation.
Conclusion: The subcutaneous pocket graft could be chosen in thumb tip amputation in case of impossible microvascular anastomosis as well as who strongly desires to preserve thumb tip after failed replantation.

Key Words: Thumb tip amputation, Subcutaneous pocket graft

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