| Management of Failed Thumb Replantation (Early Soft Tissue Removal with Vascularized Flap Coverage of Amputated Phalangeal Bone) |
|
Duke Whan Chung, M.D. and Ki Bong Kim, M.D. |
| 무지 재접합 실패예에 대한 조기 치료로서 절단부의 수지골과 유리 피판술을 이용한 무지의 재건 |
|
정덕환·김기봉 |
|
|
|
|
| Abstract |
Failure of replantation is inevitable in finger replantation surgery, around 10% of failure rate are reported in many authors. Management of the failed finger replantation is one of big dilemma to microsurgeons. We report 5 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as revered radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed.
All of the flaps are survived, bone union achieved within 3 months . The function and external appearance of the reconstructed thumb were encouraging; pinch power was average 1.2 pounds.
Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand. |
| Key Words:
Thumb, Failed replantation, Early soft tissue removal with vasculariazed flap coverage |
| |
|
PDF Links
Full text via DOI
Download Citation
