PDF(Pubmed)
Abstract：
Traumatic thumb injuries often result in significant functional disability. With segmental bone loss, reconstructive options include antibiotic cement with delayed bone graft, revision amputation with webspace deepening, metacarpal distraction osteogenesis, index pollicization, bone flap, and free toe transfer. We present a case of a subtotal thumb amputation just distal to the metacarpal phalangeal joint resulting in loss of both soft tissue and a segmental bone defect of the proximal and distal phalanx. Reconstruction was initially performed with a chimeric bone free flap from the medial femoral condyle with a vastus medialis muscle cuff to provide soft tissue coverage. A revision soft tissue coverage procedure was required and a radial forearm free flap was utilized. His reconstruction restored his missing bone and soft tissue, and provided stability with sufficient grip strength and metacarpophalangeal function resulting in a satisfactory functional outcome.
摘要：
创伤性拇指损伤通常导致显著的功能性残疾。节段性骨丢失，重建的选择包括抗生素水泥与延迟骨移植，随着网络空间的深化，修订截肢，掌骨牵张成骨，索引极化，骨瓣,和自由脚趾转移。我们介绍了一例拇指次全截肢的病例，该截肢位于掌指骨关节的远端，导致软组织丢失以及近端和远端指骨的节段性骨缺损。最初使用来自股骨内侧髁的嵌合无骨瓣进行重建，并带有股内侧肌肉袖带以提供软组织覆盖。需要进行翻修软组织覆盖手术，并使用了radial前臂游离皮瓣。他的重建恢复了他丢失的骨头和软组织,并提供足够的握力和掌指骨功能的稳定性，从而获得令人满意的功能结果。
