Reconstruction of Amputated Thumb through Lengthening of First Metacarpal View Full Text


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Article Info

DATE

2002-12

AUTHORS

Robert Zimmermann

ABSTRACT

ObjectiveRestoration and/or improvement of pinch and grasp through elongation of the first metacarpal and deepening of the first web space.IndicationsFunctional limitation of thumb, in particular of pinch and grasp after traumatic amputation in zone 2 according to Strickland & Kleinman.ContraindicationsInadequate skin and soft tissue coverage of amputation stump.Absence of sensation over stump.Osteoarthritis of trapezometacarpal joint.Osteoporosis.Insufficient compliance and lack of comprehension by patient.Surgical TechniqueFirst step: placement of unilateral minifixateur. Posteroradial incision and osteotomy of the first metacarpal.Phase of distraction: continuous distraction starting on day 7, 1 mm per day.Second step: once the desired length has been reached, bridging of the distraction callus with a miniplate and deepening and enlargement of first web space using a local skin flap.ResultsBetween 1998 and 2000, ten patients (nine men, one woman, aged between 15 and 68 years) were treated. The amputation occurred four times in zone 2a and six times in zone 2b. An isolated injury to the thumb was seen nine times, and once one of the other fingers was involved. The desired gain in length was reached in nine patients, it amounted to 31 mm (25–35 mm). Strength of pinch improved by an average of 45% and that of grasp by 55%. More... »

PAGES

258-267

References to SciGraph publications

  • 2000-11. Die Kallusdistraktion des ersten Mittelhandknochens zur Daumenrekonstruktion nach traumatischer Amputation in DER UNFALLCHIRURG
  • 1996. Unterarm- und Metakarpalverlängerung in EXTREMITÄTENVERLÄNGERUNG DEFORMITÄTENKORREKTUR PSEUDARTHROSENBEHANDLUNG
  • 1997-06. Daumenrekonstruktion durch kontinuierliche Verlängerung des ersten Mittelhandknochens in OPERATIVE ORTHOPÄDIE UND TRAUMATOLOGIE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00065-002-1054-8

    DOI

    http://dx.doi.org/10.1007/s00065-002-1054-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1040293899


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