For crushing injury of the hand that involves 4-digit amputations sparing the thumb, lengthening of amputated stump and covering the defect are important for hand function. From March 2007 to September 2011, the authors performed "reverse on-top plasty" in 5 patients. The fifth metacarpal bone was disarticulated, turned over 180 degrees, and embedded in reverse direction so that the metacarpal base becomes the tip of new finger. Soft tissue defects were covered using anterolateral thigh free flap or reverse radial forearm flap. The mean follow-up period was 21.2 months, and major complications such as bony resorption did not occur. Static 2-point discrimination showed fair recovery of fingertip sense. Key pinch power was 76.4% of the uninjured hand. In conclusion, reverse on-top plasty is good in gaining more sufficient finger length and durability using cartilaginous portion of the fifth metacarpal bone than the previously used on-top plasty.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/SAP.0b013e3182650cc6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
On-Top Osteotomy of the Phalanx Base Combined With Modified Bilhaut: Cloquet Procedure for Atypical Radial Polydactyly.
Cureus
January 2024
Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN.
In this report, we present the combination of on-top plasty with a modified Bilhaut-Cloquet procedure for treating atypical radial polydactyly with duplication at the metacarpophalangeal (MP) joint and triphalangism of the radial and ulnar phalanges, hypoplastic middle phalanx of the radial thumb, and hypoplastic phalanx base of the ulnar thumb. To preserve the stable MP and interphalangeal joints of the radial and ulnar thumbs, respectively, on-top plasty involved osteotomizing the middle phalanx and transferring the distal end of the middle phalanx of the ulnar finger to the phalanx base of the radial thumb. A modified Bilhaut-Cloquet procedure was used to combine the tips and nails of both thumbs.
View Article and Find Full Text PDFAtypical Wassel type VI thumb duplication treated with on-top plasty.
JPRAS Open
March 2024
Deparment of Surgery, University Hospital Centre Split, Spinčićeva 1, 21000 Split, Croatia.
Congenital thumb duplication is estimated to occur between 0.08 and 7.6 times per 1,000 live births; however its cause is still undetermined.
View Article and Find Full Text PDFOn-top plasty combined with modified Bilhaut-Cloquet procedure for reconstructing complicated radial polydactyly.
J Plast Reconstr Aesthet Surg
November 2023
Department of Pediatric Orthopaedics, Children's Hospital of Soochow University, Suzhou, Jiangsu, China. Electronic address:
Purpose: To present a surgical technique of combining the on-top plasty with modified Bilhaut-Cloquet procedure for reconstructing a rare type of complicated radial polydactyly and evaluate the outcomes.
Methods: Fourteen complicated radial polydactyly in 13 patients were corrected by combining the on-top plasty with modified Bilhaut-Cloquet procedure. Osteotomies were performed as required, and the acral part of the ulnar thumb was transposed onto the proximal part of the radial thumb.
On-top-plasty reconstruction for thumb triplication.
JPRAS Open
December 2023
Department of Plastic Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
Thumb triplication is a very rare pattern of radial polydactyly that presents as a more complicated form of thumb. Because of its morphological complexity, treatment often requires surgical ingenuity in addition to the conventional surgical treatment algorithms for duplication. We report the case of thumb triplication on the right hand of a 17-month-old boy.
View Article and Find Full Text PDFClassification of radial polydactyly based on physical characteristics.
Pediatr Neonatol
March 2024
Department of Paediatric Orthopaedics, Bone and Joint Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. Electronic address:
Article Synopsis
- The study developed a new algorithm for classifying thumb polydactyly based on physical characteristics rather than just radiographic levels of duplication.
- It categorized conditions into hypoplastic, symmetric (adequate/inadequate), and asymmetric (ulnar/radial dominant) types using four key traits: floating, symmetry, dominant side, and joint characteristics.
- A retrospective analysis of 500 patients showed that the new classification effectively predicted treatment options, helping pediatricians and parents navigate surgical decisions despite not detailing surgical techniques.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!