scholarly journals Thumb Reconstruction Using Foucher’s Flap

2016 ◽  
Vol 4 (1) ◽  
pp. 70-73
Author(s):  
Nardi Kola
Keyword(s):  
Donor Site ◽  
Reconstruction Method ◽  
Thumb Reconstruction ◽  
Pedicle Flap ◽  
Cold Intolerance ◽  
Extensor Pollicis Longus ◽  
Flap Survival ◽  
Work Related ◽  
Dorsal Metacarpal Artery ◽  
Web Reconstruction

BACKGROUND: Extensive pulp defects of the thumb, with the exposure of tendon or bone, are challenging reconstructive problems. Surgical treatment includes the use of local, regional, and free flaps.AIM: This paper is focused in Foucher’s neuro vascular flap. First DMCA or Foucher’s pedicle flap is a successful thumb reconstruction method, especially in patients not disturbed by its cosmetic appearance.MATERIAL AND METHODS: The first dorsal metacarpal artery (FDMCA) arises from the radial artery in the first intermetacarpal space, just distal to the tendon of the extensor pollicis longus. Pulp area of the thumb is the area where Foucher’s flap is more utilizable. This technique has other applications such as first web reconstruction, thumb lengthening, and following resection of tumors on the dorsum of the hand.RESLTS: We have in study 7 cases with work related trauma in two years period of time, between 2012 and 2014. We had only one partial flap survival and all the other flaps survived entirely. We have also taken in consideration subjective satisfaction with a range score from 4 to 10, cold intolerance, flap area and donor site sensibility with a range score from low to medium to normal.CONCLUSION: Careful pedicle discovery, secured elevation, pedicle strangulation prevention are very important for flap survival.

A Comparative Study of the Heterodigital Neurovascular Island Flap in Thumb Reconstruction, with and without Nerve Reconnection

1994 ◽  
Vol 19 (5) ◽  
pp. 552-559 ◽  
Author(s):  
R. ADANI ◽  
P. B. SQUARZINA ◽  
C. CASTAGNETTI ◽  
A. LAGANÁ ◽  
G. PANCALDI ◽  
...  
Keyword(s):  
Donor Site ◽  
Functional Results ◽  
Flap Reconstruction ◽  
Hypertrophic Scarring ◽  
Digital Nerve ◽  
Thumb Reconstruction ◽  
Cold Intolerance ◽  
Scar Contracture ◽  
Sensory Acuity

41 heterodigital neurovascular island flaps were used to cover defects of the tactile pad of the thumb in 17 years. With an average follow-up of 75.5 months, 30 patients were reviewed. 17 were treated by the original Littler technique and 13 were treated with the same flap reconstruction but with division of the digital nerve innervating the flap and re-anastomosis of this nerve to the proximal nerve end of the ulnar digital nerve of the thumb. Good aesthetic and functional results were achieved in both groups. Sensory acuity did not appear to decrease with time. The nerve reconnection technique solves the “double sensibility” phenomenon (present in 41.1% of our cases treated by the original technique), but two-point discrimination is less than that achieved by the Littler technique. Most complaints were related to the donor site such as hypertrophic scarring or scar contracture and cold intolerance, but these did not cause any real functional impairment.

Distal Thumb Reconstruction Using a Mini Wrap-Around Flap from the Great Toe

1999 ◽  
Vol 24 (4) ◽  
pp. 437-442 ◽  
Author(s):  
R. ADANI ◽  
L. J. CARDON ◽  
C. CASTAGNETTI ◽  
M. PINELLI
Keyword(s):  
Donor Site ◽  
Distal Phalanx ◽  
Interphalangeal Joint ◽  
Reconstruction Technique ◽  
Significant Morbidity ◽  
Great Toe ◽  
Thumb Reconstruction ◽  
Cold Intolerance

We have used a great toe mini wrap-around flap for reconstruction of the thumb at, or distal to, the interphalangeal joint. Our series included 12 patients with traumatic amputations. A flap including the entire nail and most of the distal phalanx of the great toe was used. Eleven of the grafts survived. Sensibility was good with an average of 10 mm static two-point discrimination (range, 5–15) and there were no complaints of cold intolerance. All patients were pleased with the appearance of the thumb and there was no significant morbidity at the great toe donor site. The great toe mini wrap-around flap is an excellent reconstruction technique for selected patients with distal thumb amputations.

A depth camera-based full-body reconstruction method for body pose training in occupational safety

2020 ◽  
Vol 64 (1) ◽  
pp. 1541-1545
Author(s):  
Li Li ◽  
Ken Chen ◽  
Karen Chen ◽  
Xu Xu*
Keyword(s):  
Occupational Injuries ◽  
Technological Development ◽  
Point Clouds ◽  
Incidence Rates ◽  
Multiple Point ◽  
Reconstruction Method ◽  
Safety Education ◽  
Depth Cameras ◽  
Work Related ◽  
Full Body

Occupational injuries have high incidence rates across various industries. Safety education is a key component to effectively reduce work-related injuries. Posture training for work safety is widely adopted to increase the awareness of unsafe movements at work and to evaluate workers to minimize work-related musculoskeletal stresses. However, existing one-size-fits-all pamphlet-based posture training is facing challenges in its effectiveness. In recent years, the substantial technological development in virtual reality (VR) and augmented reality (AR) has made immersive and personalized education possible. For VR/AR-assisted posture training, full-body reconstruction from multiple point clouds is the key step. In this study, we propose a fast and coarse method to reconstruct the full-body pose of safety instructors using multiple low-cost depth cameras. The reconstructed body images from depth cameras are registered through iterative closet point algorithm. The reconstructed full-body pose can be further rendered in VR/AR environments for next-generation safety education.

Calcaneal Reconstruction With Free Deep Circumflex Iliac Artery Osseocutaneous Flap Following Aggressive Benign Bone Tumor Resection

2021 ◽  
pp. 107110072110252
Author(s):  
Mohamad Aizat Rosli ◽  
Wan Faisham Wan Ismail ◽  
Wan Azman Wan Sulaiman ◽  
Nor Azman Mat Zin ◽  
Syurahbil Abdul Halim ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Donor Site ◽  
Tumor Resection ◽  
Case Series ◽  
Benign Tumors ◽  
Reconstruction Method ◽  
Short Term ◽  
Deep Circumflex Iliac Artery ◽  
First Case ◽  
Donor Site Pain

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.

The First Dorsal Metacarpal Artery Neurovascular Island Flap

1988 ◽  
Vol 13 (2) ◽  
pp. 136-145
Author(s):  
J. O. SMALL ◽  
M. D. BRENNEN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Island Flap ◽  
Neurovascular Flap ◽  
Dorsal Metacarpal Artery ◽  
First Dorsal Metacarpal Artery

A first dorsal metacarpal artery island flap from the index finger was used in 20 cases for reconstruction of defects in the hand. In six cases it was used as a neurovascular flap for sensory resurfacing of the thumb and in five cases for release of a contracted first web. One flap underwent necrosis and there was a complication in one donor site.

Extensor Indicis Opposition Transfer in The Ulnar and Median Palsied Thumb in Leprosy

1996 ◽  
Vol 21 (5) ◽  
pp. 617-621 ◽  
Author(s):  
R. MEHTA ◽  
G. N. MALAVIYA ◽  
S. HUSAIN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Pollicis Longus ◽  
Extensor Pollicis Longus ◽  
Extensor Indicis Proprius ◽  
Leprosy Patients ◽  
Significant Deficit

Twenty seven opponensplasties for ulnar and median paralysis in 25 leprosy patients were performed using extensor indicis proprius. An additional transfer of the radial half of flexor pollicis longus to extensor pollicis longus was done to stabilize the metacarpophalangeal joint of the thumb. The biomechanical aspects of extensor indicis proprius tendon transfer were studied and results evaluated using various anatomical and functional parameters. Extensor indicis proprius provides adequate strength to position the thumb. However, sometimes it does not reach its new insertion. There is no significant deficit at the donor site but in a few cases the index finger may lose its capability for independent extension and sometimes a proximal interphalangeal joint contracture may develop.

The Bilobed Racquet Flap or Extended Seagull Flap for Thumb Reconstruction: A Case Report

2018 ◽  
Vol 23 (01) ◽  
pp. 128-131
Author(s):  
José Couceiro ◽  
Mariangeles De la Red-Gallego ◽  
Luis Yeste ◽  
Higinio Ayala ◽  
Manuel Sanchez-Crespo ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Thumb Reconstruction ◽  
Degloving Injury ◽  
Dorsal Metacarpal Artery ◽  
The Subject ◽  
Tissue Defects

The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition. We report the salvage of a thumb degloving injury with use of a bilobed racquet flap.

The Second Dorsal Metacarpal Artery Neurovascular Island Flap

1989 ◽  
Vol 14 (4) ◽  
pp. 434-440
Author(s):  
M. J. EARLEY
Keyword(s):  
Donor Site ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Island Flap ◽  
Arterial Supply ◽  
Flap Necrosis ◽  
Local Skin ◽  
Skin Defects ◽  
Dorsal Metacarpal Artery

Eleven patients have had second dorsal metacarpal sensate island flaps used to cover local skin defects in the hand. The arterial supply is reliable but if the flap is extended beyond the proximal interphalangeal joint, distal flap necrosis or donor site difficulties may occur. Possible applications for this flap are demonstrated and some untried variations to increase its range are suggested. Its main use appears to be in the release of first web contractures and for resurfacing radio-palmar and thumb defects.

scholarly journals Reverse-Flow Posterior Interosseous Flap—A Review of 68 Cases

Hand ◽  
2007 ◽  
Vol 2 (3) ◽  
pp. 112-116 ◽  
Author(s):  
Tahseen A. Cheema ◽  
Shankar Lakshman ◽  
Mohammad Amin Cheema ◽  
Shakeel Farrukh Durrani
Keyword(s):  
Soft Tissue ◽  
Reverse Flow ◽  
Fasciocutaneous Flap ◽  
Soft Tissue Coverage ◽  
Thumb Reconstruction ◽  
Flap Survival ◽  
Partial Necrosis ◽  
Hand Defects ◽  
Web Space

We are reporting our 10-year experience with 68 patients. Sixty-six flaps were of fasciocutaneous type and two were of osteofasciocutaneous type. These flaps were used for volar and dorsal traumatic hand defects, first web space reconstruction, thumb reconstruction, and repair of congenital anomalies. Sixty flaps (88.24%) had complete uneventful take-up. Four flaps developed partial necrosis, whereas four flaps suffered complete necrosis. The single most important factor for flap survival in our experience has been inclusion of at least two perforators to supply the skin pedal. The proximal flap dissection has a learning curve and all of our poor results were in the early part of our experience. We believe that posterior interosseous fasciocutaneous flap (PIF) is a versatile and reliable option for the challenging problems of hand soft-tissue coverage.

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.

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