J Korean Soc Microsurg.  2011 Nov;20(2):126-131.

Thumb Tip Reconstruction with Subcutaneous Pocket Graft: 2 Cases Report

• Lee YK
• Moon YJ
• Lee JM

Abstract

PURPOSE
The subcutaneous pocket graft of the thumb tip amputation across or proximal to the lunula is chosen in case of impossible microvascular anastomosis and in patient who strongly desired to preserve the thumb tip after failed replantation.
MATERIALS AND METHODS
Two patients who underwent a subcutaneous pocket graft for a thumb tip reconstruction between August 2008 and November 2009 were reviewed retrospectively. They were all males with a mean age at the time of surgery of 48 years and had sustained complete thumb tip amputations across or proximal to the lunula. In one case, the microsurgical replantation was not feasible and the other one revealed arterial insufficiency at the 7th day after microsurgical replantation.
RESULTS
Authors had experienced 2 cases of flaps which survived completely. The results of sensibility was good, the range of motion at interphalangeal joint and tip to tip pinch was acceptable and color mismatch and loss of thumb finger nail was unacceptable after more than 1 year follow up with conventional successful thumb tip replantation.
CONCLUSION
The subcutaneous pocket graft could be chosen in thumb tip amputation in case of impossible microvascular anastomosis as well as who strongly desires to preserve thumb tip after failed replantation.

Keyword

Thumb tip amputation; Subcutaneous pocket graft

MeSH Terms

Amputation
Fingers
Follow-Up Studies
Humans
Joints
Male
Nails
Range of Motion, Articular
Replantation
Retrospective Studies
Thumb
Transplants