J 2013

Further Developments in the Twisted-Toe Technique for Isolated Thumb Reconstruction: Our Method of Choice

KEMPNÝ, Tomáš, Jiri PAROULEK, Vladimir MARIK, Pavel KURIAL, Břetislav LIPOVÝ et. al.

Basic information

Original name

Further Developments in the Twisted-Toe Technique for Isolated Thumb Reconstruction: Our Method of Choice

Authors

KEMPNÝ, Tomáš (203 Czech Republic), Jiri PAROULEK (203 Czech Republic), Vladimir MARIK (203 Czech Republic), Pavel KURIAL (203 Czech Republic), Břetislav LIPOVÝ (203 Czech Republic, guarantor, belonging to the institution) and Georg M. HUEMER (40 Austria)

Edition

PLASTIC AND RECONSTRUCTIVE SURGERY, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2013, 0032-1052

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.328

RIV identification code

RIV/00216224:14110/13:00071792

Organization unit

Faculty of Medicine

DOI

UT WoS

000319567500001

Keywords in English

GREAT-TOE; FLAP

Tags

International impact, Reviewed
Změněno: 8/3/2021 08:40, Mgr. Tereza Miškechová

Abstract

V originále

Background: Posttraumatic loss of the thumb is devastating. Toe-to-hand transfer is considered the criterion standard of reconstruction but is associated with donor-site issues. The twisted-toe technique uses parts from the great toe and the second toe, which allows for almost anatomical restoration of the donor foot. The authors present their experience and technical modifications of this method. Methods: Between January of 2003 and November of 2011, 18 patients suffering from loss of thumb because of a variety of indications were treated with the authors' modification of the twisted-toe technique. The neothumb was constructed with a partial onychocutaneous flap from the great toe and an osseotendinous flap from the second toe. Results: Of 18 transplanted twisted-toe flaps, 17 survived completely (5.6 percent flap loss rate). Similarity of the reconstructed thumb compared with the healthy side was very acceptable in all cases. All patients in whom the procedure was successful were able to use the neothumb in daily life without constraints. Reconstruction of the donor site yielded very acceptable outcomes with a distinct reduction in morbidity and disfigurement compared with conventional toe harvest. Conclusions: The modified twisted-toe technique is the authors' preferred choice of thumb reconstruction. It allows the reconstructive surgeon to construct a very natural-appearing neothumb with good stability and grip force. In addition, it eliminates many of the donor-site problems associated with pure great toe harvest, by recreating a "neo-great toe" at the donor foot. Although the procedure is more complicated and time-consuming compared with single toe harvest, the authors firmly believe that this extra effort takes thumb reconstruction to a next level.