Microsurgical Reconstruction of the Hypoplastic Thumb, Type IIIB

2001 ◽  
Vol 17 (01) ◽  
pp. 009-016 ◽  
Author(s):  
Guy Foucher ◽  
Jose Medina ◽  
Ricardo Navarro
Keyword(s):  
Microsurgical Reconstruction ◽  
Type Iiib ◽  
Hypoplastic Thumb

Reconstruction of hypoplastic thumb using hemi-longitudinal metatarsal transfer

2011 ◽  
Vol 37 (8) ◽  
pp. 738-744 ◽  
Author(s):  
C. S. Chow ◽  
P. C. Ho ◽  
W. L. Tse ◽  
L. K. Hung
Keyword(s):  
Hand Function ◽  
Donor Site ◽  
Normal Growth ◽  
Wound Complication ◽  
Reconstruction Method ◽  
Type Iiib ◽  
Contralateral Hand ◽  
Permanent Morbidity ◽  
Hypoplastic Thumb

The treatment of hypoplastic thumb (modified Blauth’s type IIIb and IV) by pollicization is culturally unfavourable in the Chinese population and digit preservation is preferred. An innovative reconstruction method using a nonvascularized hemi-longitudinal metatarsal graft was performed in six cases with an average follow-up of 87.7 months. Overall hand function was good, as assessed using the Jebsen hand function test. Grip strength and pinch power were significantly weaker than the normal contralateral hand. There was no neurovascular or wound complication. The only donor site complication was a metatarsal fracture, which healed uneventfully with casting. There had been no permanent morbidity to the donor site, as all donor metatarsals hypertrophied and regained normal growth potentials. Linear growth of the transferred metatarsals was evident radiologically (average 1.5 mm/year). Free hemi-longitudinal metatarsal transfer is a feasible method with good functional outcome in the attainment of a 5-digit hand in patients with type IIIb/IV hypoplastic thumb.

scholarly journals A Case of a 5-Year-Old Boy with a Blauth Type IIIB Hypoplastic Thumb Reconstructed with a Nonvascularized, Hemilongitudinal Metatarsal Transfer

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mika Nakada ◽  
Kaoru Tada ◽  
Tadahiro Nakajima ◽  
Masashi Matsuta ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Postoperative Complications ◽  
Metatarsal Bone ◽  
Treatment Methods ◽  
Type Iiib ◽  
Hypoplastic Thumb ◽  
Growth Disorder

The treatment methods used for Blauth type IIIB hypoplastic thumbs are controversial. We performed a nonvascularized, hemilongitudinal metatarsal bone transfer on a 5-year-old boy with a type IIIB hypoplastic thumb. Despite the child’s age, the growth of the thumb was confirmed and the thumb had stabilized. Moreover, growth disorder of the donor toe was not observed. This method is relatively easy to perform. And donor toe deformation can be prevented, because of the preservation of more than half of the metatarsal bone. In our case, the patient was 5 years of age; nevertheless, the epiphyseal line was opened and the grafted metatarsal bone grew. This method is useful in terms of its simplicity and prevention of postoperative complications.

scholarly journals HYPOPLASTIC THUMB TYPE IIIB: AN ALTERNATIVE METHOD FOR SURGICAL REPAIR

2014 ◽  
pp. 1
Author(s):  
Salih Basat ◽  
Cagdas Orman ◽  
Turgut Kayadibi ◽  
Ilker scetin ◽  
Mehmet Bozkurt
Keyword(s):  
Surgical Repair ◽  
Type Iiib ◽  
Alternative Method ◽  
Hypoplastic Thumb

Association between lumbar sacralization and increased degree of vertebral slippage and disc degeneration in patients with L4 spondylolysis

2019 ◽  
Vol 30 (6) ◽  
pp. 767-771
Author(s):  
Xinqiang Yao ◽  
Ruoting Ding ◽  
Junhao Liu ◽  
Siyuan Zhu ◽  
Jingshen Zhuang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Disc Degeneration ◽  
Transverse Process ◽  
Modic Changes ◽  
Bony Fusion ◽  
Transitional Vertebra ◽  
Type Iiia ◽  
Type Iiib ◽  
Significant Difference ◽  
Lumbosacral Transitional Vertebra

OBJECTIVEThe aim of this study was to evaluate the effect of lumbar sacralization on the level of vertebral slip and disc degeneration in patients with L4 spondylolysis.METHODSThe authors analyzed data from 102 cases in which patients underwent surgical treatment for L4 spondylolysis and spondylolisthesis at their institution between March 2007 and September 2016. Lumbar sacralization was characterized by the presence of pseudarthrosis and/or bony fusion between the L5 transverse process and sacrum, and the type of lumbosacral transitional vertebra (LSTV) was evaluated with the Castellvi classification. The amount of vertebral slippage was measured using the Taillard technique and Meyerding grade. Degeneration of the L4–5 segment was quantified using the Pfirrmann and Modic classifications. Patients were divided into 2 groups based on the presence or absence of sacralization, and the amount of vertebral slip and degeneration of the L4–5 segment was compared between groups.RESULTSLumbar sacralization was present in 37 (36%) of 102 patients with L4 spondylolysis. The LSTV was type IIa in 10 cases, type IIb in 7, type IIIa in 2, and type IIIb in 18. The levels of vertebral slip and disc degeneration in the group of patients with sacralization were significantly greater than in the group without sacralization. No significant difference was found between the 2 groups with respect to Modic changes.CONCLUSIONSThe increased stability between a sacralized L5 and the sacrum may predispose the L4–5 segment to greater instability and disc degeneration in patients with L4 spondylolysis.

Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review

2021 ◽  
pp. 194338752110264
Author(s):  
Sean A. Knudson ◽  
Kristopher M. Day ◽  
Patrick Kelley ◽  
Pablo Padilla ◽  
Ian X. Collier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Planning ◽  
Average Length ◽  
Case Series ◽  
Retrospective Case ◽  
Oral Nutrition ◽  
Microsurgical Reconstruction ◽  
Virtual Surgical Planning ◽  
And Function ◽  
Ballistic Trauma

Study Design: Retrospective case series; systematic review. Objective: It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion. Methods: A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis. Results: Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline. Conclusions: Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.

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