Open AccessAcute Thumb Reconstruction With Medial Femoral Condyle and Radial Forearm Free Flaps: A Case Report
Author(s) -
Andrew P. Golin,
Zach Zhang,
Imran Ratanshi,
Colin W. McInnes
Publication year - 2022
Publication title -
hand
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.722
H-Index - 35
eISSN - 1558-9455
pISSN - 1558-9447
DOI - 10.1177/15589447221096705
Subject(s) - medicine , soft tissue , thumb , metacarpophalangeal joint , forearm , surgery , amputation , free flap , condyle , anatomy
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.