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Component Separation of the Index Finger to Reconstruct the Thumb: Case Report With Review of Literature

Mishra, Anuj MS, MRCS; Whitaker, Iain S. BA (Hons), MBBChir, MA Cantab, MRCS; Josty, Ian C. BSc, FRCS, FRCS (Plast)

doi: 10.1097/SAP.0b013e318168d2e2
Hand Surgery and Microsurgery

Treatment options for severely damaged finger joints include amputation, arthroplasty, arthrodesis, and reconstruction using nonvascularized or vascularized joint transfers. The thumb contributes significantly to global hand function, and functioning metacarpophalangeal and interphalangeal joints are crucial. When 2 adjacent joints are damaged by trauma, vascularized joint transfer from an injured index finger to the thumb is an option to maximize remaining thumb function. Complex composite injuries involving joints, soft tissues, and tendons require customized reconstructive solutions to retain and optimize hand function. We present a case of component separation of an injured index finger as the donor area for 2 flaps to reconstruct a complex bone, joint, and soft tissue thumb defect, which resulted in a high level of patient satisfaction and a return to heavy manual work.

From the Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Morriston, UK.

Received July 28, 2007 and accepted for publication, after revision, January 8, 2008.

Reprints: Iain S. Whitaker, BA (Hons), MBBChir, MA Cantab, MRCS, Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Morriston SA6 6NL United Kingdom. E-mail: iainwhitaker@fastmail.fm.

© 2008 Lippincott Williams & Wilkins, Inc.