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17 Special Types ofFinger Reconstruction
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Fig. 17.15 Reconstruction of the left thumb by temporary heterotopic
replantation of the residual nger body in the second stage. (a)
Preoperative radial condition of the left thumb. (b) Preoperative palmar
condition of the left thumb. (c) Preoperative dorsal condition of the left
thumb. (d) Preoperative X-ray. (e) Temporary heterotopic replantation
skin defect area was about 3 × 4cm. The severed nger was
wrapped and preserved with gauze, the nger abdomen and
ngernail were black, the skin and soft tissue were avulsed to
the interphalangeal joint, and the interphalangeal joint was
committed fracture. The exor pollicis longus tendon and
extensor pollicis longus tendon were avulsed about 25 cm,
and bilateral digital nerves were avulsed about 8cm. The
avulsion of bilateral digital proper arteries was about 4 cm,
and the avulsed vessels, nerves, and tendons were seriously
polluted. After admission, routine preoperative preparation
for reconstruction was given, and surgical contraindications
were excluded. Wound debridement and VSD operation
were performed under general anesthesia in an emergency.
The severed nger was connected to the anterolateral thigh
in emergency. (f) The survived foster nger 3 weeks after the operation.
(g) The appearance of the rst web space 1 year after the operation. (h)
The abduction function of the reconstructed nger 1 year after the operation. (i) The opponens function of the reconstructed nger 1 year after
the operation
perforator ap to complete temporary heterotopic replantation. The left thumb was reconstructed by the surviving foster nger combined with the composite anterolateral thigh
ap under general anesthesia in the second stage. Routine
reconstruction treatment was given after the operation. The
reconstructed nger survived successfully. Regular follow up was conducted to guide functional exercise for 12 months.
The appearance and function of the reconstructed nger
were satisfactory (Fig.17.16).
Case 4 The 39-year-old male patient was admitted to the
hospital for 8 h due to pain and bleeding of the severed left
thumb caused by a machine. Physical examination: He was
in good general condition, with stable vital signs. Defect of
17.6 Temporary Heterotopic Replantation (Reconstruction) ofSevered Fingers
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
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Fig. 17.16 Reconstruction of the left thumb by temporary heterotopic
replantation of the residual nger body. (a) Preoperative condition of
the left thumb. (b) The situation of the left thumb after debridement. (c)
The design of temporary heterotopic replantation. (d) Dissociation of
the ap. (e) Soft tissue defect of the thumb repaired by the ap. (f)
Blood supply of the foster nger. (g) VSD. (h) The situation of the
skin and soft tissue from the distal ulnar side of the right
forearm to the rst nger web space, comminuted fracture of
the distal ulna; open fracture of the right thumb, and relatively intact dorsal skin; the right index and middle ngers
were torn and severed at the metacarpophalangeal joint. The
distal nger bodies were relatively complete and connected
with the nger web, and the metacarpophalangeal joints
were damaged. The fourth and fth metacarpal bones were
foster nger 15 days after the operation. (i) Dissociation of the foster
nger. (j) The appearance and exor function of the reconstructed
thumb 1 year after the operation. (k) The function of the reconstructed
hand 1 year after the operation. (l) The appearance of the donor site 1
year after the operation
damaged from the base and the wound surface was seriously
polluted. There was no condition for orthotopic replantation.
Debridement was performed and the index and middle ngers were transferred to the dorsum of the right foot under
brachial plexus epidural anesthesia in an emergency. After a
blood transfusion, the foster ngers were ruddy in color. The
right forearm and hand were covered by VSD after debridement. A free anterolateral thigh ap was transplanted to
278
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17 Special Types ofFinger Reconstruction
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Fig. 17.17 Reconstruction of the ght hand by temporary heterotopic
replantation of the residual nger bodies in the second stage. (a)
Preoperative palmar condition of the right hand. (b) The residual part of
the thumb. (c) The appearance of the right hand after debridement. (d)
Preoperative X-ray. (e) Temporary hetertopic replantation. (f) The sur-
repair the wounds of the forearm and hand at an elective
time. After the wounds healed, the thumb and index nger
were reconstructed by the foster index nger and middle nger, respectively. Routine reconstruction treatment was given
after the operation. The reconstructed nger survived successfully. Regular follow-up was conducted to guide functional exercise. The appearance and function of the
reconstructed nger were satisfactory (Fig.17.17).
vived foster ngers 3 weeks after the operation. (g) X-ray of the foster
ngers. (h) The appearance of the right hand after VSD treatment. (i)
The design of the ap. (j) Wound repair by the ap. (k) Temporary
heterotopic reconstruction. (l)The appearance of the reconstructed hand
1 month after the operation
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