{"title":"髂嵴植骨与前臂桡侧皮瓣用于拇指重建:病例报告","authors":"","doi":"10.1016/j.tcr.2024.101106","DOIUrl":null,"url":null,"abstract":"<div><p>Traumatic thumb amputation is a serious injury that requires replantation or reconstruction. Toe-to-thumb transfers method have great survival and patient satisfaction in thumb reconstruction. Alternative method like Iliac Crest Bone Graft (ICBG) with flaps may help surgeons achieve maximum results. A 32-year-old male presented with occupational traumatic right thumb amputation. After initial debridement and K-wire installation, the thumb became necrotic. An ICBG with radial forearm flap was performed after the patient denied a toe-to-thumb transfer. Follow-up demonstrated viable flap, no infection, good joint mobility, and improved Kapandji and DASH scores. Osteoplastic reconstruction of the thumb using ICBG method is valuable for amputations around the metacarpophalangeal level preserving native anatomy and function. Radial forearm flaps are advantageous due to their thin, pliable and ability to preserve the radial artery. However, donor morbidity and potential complications should be considered. ICBG with radial forearm flap showed promising result.</p></div><div><h3>Level of evidence</h3><p>Level IV (Therapeutic).</p></div>","PeriodicalId":23291,"journal":{"name":"Trauma Case Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352644024001298/pdfft?md5=63f1ac9ffd3e5ddff863808f4a6ecdac&pid=1-s2.0-S2352644024001298-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Iliac crest bone graft with radial forearm flap for thumb reconstruction: A case report\",\"authors\":\"\",\"doi\":\"10.1016/j.tcr.2024.101106\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Traumatic thumb amputation is a serious injury that requires replantation or reconstruction. Toe-to-thumb transfers method have great survival and patient satisfaction in thumb reconstruction. Alternative method like Iliac Crest Bone Graft (ICBG) with flaps may help surgeons achieve maximum results. A 32-year-old male presented with occupational traumatic right thumb amputation. After initial debridement and K-wire installation, the thumb became necrotic. An ICBG with radial forearm flap was performed after the patient denied a toe-to-thumb transfer. Follow-up demonstrated viable flap, no infection, good joint mobility, and improved Kapandji and DASH scores. Osteoplastic reconstruction of the thumb using ICBG method is valuable for amputations around the metacarpophalangeal level preserving native anatomy and function. Radial forearm flaps are advantageous due to their thin, pliable and ability to preserve the radial artery. However, donor morbidity and potential complications should be considered. ICBG with radial forearm flap showed promising result.</p></div><div><h3>Level of evidence</h3><p>Level IV (Therapeutic).</p></div>\",\"PeriodicalId\":23291,\"journal\":{\"name\":\"Trauma Case Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2352644024001298/pdfft?md5=63f1ac9ffd3e5ddff863808f4a6ecdac&pid=1-s2.0-S2352644024001298-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Trauma Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2352644024001298\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Trauma Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352644024001298","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
外伤性拇指截肢是一种需要再植或重建的严重损伤。在拇指重建中,趾拇指转移法的存活率和患者满意度都很高。髂嵴骨移植(ICBG)和皮瓣等替代方法可帮助外科医生达到最佳效果。一名 32 岁的男性因职业创伤导致右手拇指截肢。经过初步清创和安装 K 线后,拇指开始坏死。在患者拒绝脚趾到拇指的转移后,医生为他实施了带有前臂桡侧皮瓣的ICBG手术。随访结果显示,皮瓣存活,无感染,关节活动度良好,Kapandji 和 DASH 评分均有所改善。使用 ICBG 方法对拇指进行骨整形重建,对于掌指关节周围的截肢手术很有价值,可以保留原有的解剖结构和功能。前臂桡动脉瓣因薄、柔韧且能保留桡动脉而具有优势。但应考虑供体的发病率和潜在并发症。使用桡侧前臂皮瓣进行ICBG显示了良好的效果。
Iliac crest bone graft with radial forearm flap for thumb reconstruction: A case report
Traumatic thumb amputation is a serious injury that requires replantation or reconstruction. Toe-to-thumb transfers method have great survival and patient satisfaction in thumb reconstruction. Alternative method like Iliac Crest Bone Graft (ICBG) with flaps may help surgeons achieve maximum results. A 32-year-old male presented with occupational traumatic right thumb amputation. After initial debridement and K-wire installation, the thumb became necrotic. An ICBG with radial forearm flap was performed after the patient denied a toe-to-thumb transfer. Follow-up demonstrated viable flap, no infection, good joint mobility, and improved Kapandji and DASH scores. Osteoplastic reconstruction of the thumb using ICBG method is valuable for amputations around the metacarpophalangeal level preserving native anatomy and function. Radial forearm flaps are advantageous due to their thin, pliable and ability to preserve the radial artery. However, donor morbidity and potential complications should be considered. ICBG with radial forearm flap showed promising result.
期刊介绍:
Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.