Minimally Invasive Reconstruction of an Allen Three Traumatic Thumb Injury with Platelet-rich Fibrin and Stacked Dermal Regeneration Template.

Introduction: The human thumb is critical for performing complex movements with the hand. Injuries to the thumb can significantly impact an individual's livelihood, and those with exposed bones or tendons have traditionally been treated with terminalization or reconstructive flap surgeries. However, many patients feel that their results could be better.

Case Report: We attempted a novel approach stacking multiple layers of a dermal regeneration template in a quest for better results. A young male teacher presented to our clinic with a 2-day-old severely injured thumb tip. Attempting to regenerate the lost fingertip, we first stacked the inner absorbable layers of the template layer-by-layer over the exposed bone and raw areas. Then, we injected platelet-rich fibrin (PRF) around the wound intraoperatively and at weekly intervals for a month to encourage soft-tissue development. After 6 months, we observed near-total soft-tissue development and good anatomical restoration of the lost thumb tip. Sensation returned to near-normal levels, with full functional recovery of the thumb and hand.

Conclusion: Our minimally invasive approach to reconstructing the distal thumb after an Allen Type 3 traumatic injury, utilizing PRF and a regenerative template, is a safe and effective alternative to traditional treatments. This innovative method has improved upon previously described results and may offer hope to many patients with severe thumb injuries.