Free neurovascular toe-(joint)-transfers compared to alternative reconstructive procedures for amputation injuries of two and tripartite fingers with substance loss.

E Brix, L Prantl, A Anker, S Klein, A Kehrer
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Abstract

Background: Complex injuries of the hand frequently result in loss of essential functional features. Common reconstructive procedures for soft tissue defects of the thumb or phalanges are locoregional flaps like Moberg-, Foucher-, Cross-Finger- or Littler flaps. Microneurovascular toe (joint-) transfers complete the arsenal of operative reconstructive procedures and allow for most detailed reconstructions. Our experiences with free toe transplants are reported and diversely discussed regarding contending procedures.

Methods: From 2010 until 2019 14 patients who received emergency or elective partial or complete toe transfers were compared with a control group (n = 12) treated with contending reconstructive procedures. Aim of the reconstructions was to cover the defect with well-vascularized, sensate tissue, while preserving length and range of motion in a reliable manner.

Results: The Kapandji score showed a significant difference (p- value = 0.04) with a score of 9.8 in comparison to control group (Kapandji index = 8.0).

Conclusion: In our heterogenic patient collective free toe transplants have proven to achieve comparable functional results for reconstruction of two and tripartite phalanxes as opposed to common local reconstructive procedures.

游离神经血管脚趾(关节)转移与替代重建程序相比,可用于两指和三指截肢损伤并伴有物质损失。
背景:复杂的手部损伤经常导致基本功能的丧失。拇指或指骨软组织缺损的常见重建程序是局部皮瓣,如Moberg、Foucher、Cross Finger或Littler皮瓣。微小神经血管脚趾(关节)转移完成了手术重建程序的武器库,并允许进行最详细的重建。我们对游离脚趾移植的经验进行了报道,并就竞争程序进行了不同的讨论。方法:从2010年到2019年,14名接受紧急或选择性部分或完全足趾转移术的患者与对照组(n = 12) 用有争议的重建程序治疗。重建的目的是用血管化良好的感觉组织覆盖缺损,同时以可靠的方式保持运动的长度和范围。结果:Kapandji评分有显著性差异(p值 = 0.04),与对照组相比得分为9.8(Kapandji指数 = 8.0)。结论:在我们的异质性患者中,集体游离脚趾移植已被证明在重建两个和三个指骨方面与常见的局部重建程序相比具有可比的功能结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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