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Plast Reconstr Surg Glob Open 2018 Nov 5;6(11):e1996. Epub 2018 Nov 5.

Department of Surgery, Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif.

Preaxial polydactyly represents an embryologic failure of formation and differentiation that is most commonly classified according to the level of bony duplication. The soft-tissue anatomy and approach to reconstruction of a Wassel VI thumb, an uncommon variant in which complete duplication begins at the metacarpals has not been extensively discussed in the literature. Here, we present 2 patients with a Wassel VI duplication and a shared soft-tissue variant of anomalous insertion of the opponens pollicis muscle onto the radial hypoplastic digit. Read More

World J Plast Surg 2019 Jan;8(1):97-105

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Thumb hypoplasia, a congenital deficiency of bony and soft tissue of thumb, is often associated with systemic syndromes like Holt-Oram syndrome, and is the second most common thumb anomaly after duplicated thumb. It has traditionally been classified into six categories, which help guide treatment including reconstruction versus pollicization (transfer of the index finger to thumb). Amputation of the thumb and pollicization is the traditional treatment for a IIIB hypoplastic thumb. Read More

Bull Hosp Jt Dis (2013) 2019 Mar;77(1):57-63

The basal joint is a collection of articulations at the base of thumb that serve an important function in the overall dexterity of the hand. The unique anatomy of the basal joint provided many evolutionary advantages to the human hand, but also made this joint susceptible to arthrosis and degenerative changes. Surgical treatment of basal joint arthritis has continued to evolve since it was first described in 1949, including excisional arthroplasty, tendon interposition, ligament reconstruction, implant arthroplasty, and arthroscopy. Read More

Bull Hosp Jt Dis (2013) 2019 Mar;77(1):11-20

A Stener lesion is a complete tear of the ulnar collateral ligament (UCL) from the thumb proximal phalanx at the level of the metacarpophalangeal (MCP) joint that is displaced superficial to the adductor pollicis aponeurosis, leading to interposition of the aponeurosis between the UCL and the MCP joint. The interposition of the adductor aponeurosis distinguishes the Stener lesion from other UCL injuries and impedes healing, thereby necessitating surgery. A thorough clinical examination, including valgus stress testing of the MCP joint, is crucial to the diagnosis. Read More

Semin Plast Surg 2019 Feb 8;33(1):17-23. Epub 2019 Mar 8.

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas.

With the advent of the Industrial Revolution, traumatic injuries of the upper extremity increased exponentially. As a result, surgeons began to reevaluate amputation as the standard of care. Following the Second World War, local and regional pedicled flaps became common forms of traumatic upper extremity reconstruction. Read More

J Hand Surg Am 2019 Mar 7;44(3):244.e1-244.e6. Epub 2018 Jul 7.

Department of Orthopedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA.

Purpose: The purpose of the study was to determine the long-term results of preaxial polydactyly reconstruction through evaluating strength, range of motion, pain, arthritis, and functional outcomes.

Methods: Patients having preaxial polydactyly reconstruction 15 to 60 years ago completed the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) Computer Adaptive Test (CAT). Aggregate scores were compared with those of the general population. Read More

Mol Clin Oncol 2019 Mar 21;10(3):339-342. Epub 2019 Jan 21.

Department of Orthopaedics and Traumatology, Saiful Anwar Hospital, Brawijaya University, Malang, Jawa Timur 65112, Indonesia.

Unicameral bone cyst (UBC) or simple bone cyst (SBC) is a benign cystic lesion commonly found in the humerus and femur that is mainly encountered during childhood. The currently available treatments for UBC of the hand commonly involve curettage, bone grafting, partial resection with or without grafting, multiple drilling, fracture immobilization and observation alone, and steroid injection. We herein report a case treated with total resection of the cyst and non-vascularized fibular graft in a 9-year-old right-handed female patient. Read More

J Pediatr Orthop 2019 Apr;39(4):163-168

Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Background: Extensor pollicis longus (EPL) tendon injury following the dorsal approach to elastic stable intramedullary nailing (ESIN) of the radius has been reported in a growing number of cases in the literature. This study includes 5 new cases from our institution as well as a comprehensive review of previously reported cases from the literature.

Methods: We conducted a retrospective chart review of all patients undergoing ESIN between January 1, 2004 and December 31, 2013 at our institution. Read More

Oper Orthop Traumatol 2019 Feb 26. Epub 2019 Feb 26.

Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland.

Objective: Elimination of pain or instability by arthrodesis of the thumb joint in functional position by dorsal plateosteosynthesis.

Indications: Painful primary or secondary arthrosis of the thumb, nonreconstructable ulnar, radial or palmar instability, posttraumatic dislocation, defect injuries, bone tumors in the region of the thumb metacarpophalangeal joint.

Contraindications: Local infection of the thumb metacarpophalangeal joint area. Read More

J Am Acad Orthop Surg Glob Res Rev 2019 Jan 23;3(1):e097. Epub 2019 Jan 23.

Trauma and Reparative Medicine Theme, Karolinska University Hospital, Solna, Sweden (Dr. Li); the Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden (Dr. Li); the Centre for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Gothenburg, Sweden (Ms. Kulbacka and Ms. Caine-Winterberge); and the Department of Orthopaedics, International Centre for Osseointegration Research, Education and Surgery (iCORES), University of California, San Francisco, CA (Dr. Brånemark); and the Department of Orthopaedics, Gothenburg University, Gothenburg, Sweden (Dr. Brånemark).

Introduction: Implantation of an osseointegrated percutaneous prosthesis provides a reconstruction alternative for thumb amputation without sacrificing donor tissues.

Methods: Thirteen thumb amputees received osseointegrated prostheses (1990 to 2014). The treatments were started with custom-designed implants. Read More

J Nepal Health Res Counc 2019 Jan 28;16(41):467-469. Epub 2019 Jan 28.

Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital, Kathmandu, Nepal.

Thumb is very important for hand function. Many options are available to reconstruct injured thumb from simple dressing (pulp injury without bone exposure) to replantation and toe transfer (significant loss of thumb length). In chronic setting, where other fingers are intact, on-top plasty can be used to reconstruct injured thumb. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Feb;33(2):199-202

Department of Pediatric Orthopaedics, Wuxi No.9 People's Hospital Affiliated to Soochow University, Wuxi Jiangsu, 214000,

Objective: To explore the effectiveness of one-stage metacarpal osteotomy, thumb opponensplasty and polygonal flap reconstruction in the treatment of congenital spade hand deformity.

Methods: Eight cases of congenital spade hand were treated between January 2013 and March 2017. There were 5 males and 3 females, with an average age of 17. Read More

J Hand Surg Am 2019 Jan 23. Epub 2019 Jan 23.

Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan.

Injuries to the ulnar collateral ligament (UCL) of the thumb are common and require prompt attention. Diagnostic findings and treatment options differ in acute and chronic injuries of the UCL. Pain and weakness of pinch and grip occur with chronic UCL instability. Read More

Plast Reconstr Surg 2019 Jan 21. Epub 2019 Jan 21.

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital,Chang Gung Medical College and Chang Gung University, Taipei, Taiwan.

Background: Patient reported outcome measures (PROMs) are an important metric in evaluating treatment efficacy of reconstructive surgery. Toe-to-hand transfer can restore vital prehensile function however this surgery is complex, extensive rehabilitation is required, and there are concerns about donor site morbidity. This study longitudinally explores the benefits of this procedure, from the patients' perspective, using PROMs. Read More

Tech Hand Up Extrem Surg 2019 Jan 22. Epub 2019 Jan 22.

Department of Orthopedic Surgery, Dankook University College of Medicine, Cheonan, Korea.

We present the case of a professional golf player who gradually developed a boutonniere deformity of the thumb due to chronic repetitive injury to the thumb and was treated with reconstruction of its insertion onto the proximal phalangeal base. The athlete showed an insertion variation of the extensor pollicis brevis, where some slips attached onto the extensor hood and the other slips ran along with the extensor pollicis longus to the distal phalanx, providing no slip to the proximal phalanx. The slips inserting to the distal phalanx were transferred to the base of the proximal phalanx and sagittal band reconstruction. Read More

Hand Surg Rehabil 2019 Jan 17. Epub 2019 Jan 17.

Service d'orthopédie et de traumatologie, CHU de Caen, avenue de la côte de nacre, 14000 Caen, France. Electronic address:

Partial trapeziectomy for basal joint arthritis is an alternative to total trapeziectomy that preserves the height of the thumb column. Using arthroscopy reduces the incidence of periarticular lesions and the risks of complications. The purpose of this prospective single-center study was to evaluate the results of arthroscopic partial trapeziectomy combined with suspension and interposition ligament reconstruction using half of the abductor pollicis longus tendon. Read More

J Plast Reconstr Aesthet Surg 2019 Jan 7. Epub 2019 Jan 7.

Department of Hand and Plastic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China. Electronic address:

Purpose: To evaluate nail appearance after nail fusion plasty to treat thumb duplication.

Methods: A modified form of nail fusion plasty was performed on 17 reconstructed thumbs of 16 children with thumb duplications, commencing in January 2010. We assessed nail width and nail, lunular, and nail fold deformities using the Wang-Gao scoring system. Read More

Kathmandu Univ Med J (KUMJ) 2018 Apr-Jun;16(62):191-195

Department of Orthopaedics, BP Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal.

Dorsal Metacarpophalyngeal joint dislocation of thumb in children is a rare occurrence. All the three different types, namely Simple Complete, Complex Complete and Incomplete dislocations have been described in this article with clinical and radiological clues to differentiate the closely reducible (simple) dislocations from irreducible ones (complex). A simple approach to treatment decision making has been adopted for all cases, starting with attempt of closed reduction which if fails, moving to open reduction. Read More

Int Orthop 2019 Mar 10;43(3):647-651. Epub 2019 Jan 10.

Sant'andrea Hospital, Traumatology Sports Center "Kilk Kilgour", "La Sapienza" University, Via Di Grottarossa, 1035-1039, Rome, RM, Italy.

Introduction: Biological arthroplasties are the most used surgical techniques, for the treatment of trapeziometacarpal osteoarthritis; all of them provide the reconstruction of trapeziometacarpal joint by a tendon graft. The aim of the study is to compare two surgical techniques: interposition arthroplasty and suspension arthroplasty at 12-month follow-up in order to evaluate the clinical and radiographic results.

Methods: Sixty-seven patients surgically treated for basal thumb osteoarthritis were divided into two groups: 36 patients, (8 M; 27 F) (39 hands), treated with interposition arthroplasty are included in group A and 31 patients, (6 M; 25 F) (34 hands), treated with suspension are included in group B. Read More

J Plast Reconstr Aesthet Surg 2018 Dec 14. Epub 2018 Dec 14.

Department of Hand Surgery, Ruihua affiliated hospital of Soochow University, No. 5 Tayun Road, Yuexi Town, Wuzhong District, Suzhou, 215104, China. Electronic address:

Combination foot flaps for digit reconstruction was previously introduced by our group as an alternative method for toe-to-hand transfer. The aim of this study was to analyze our experience with the combination foot flaps and to present the surgical refinements that were introduced. A prospective study was conducted including all combination foot flaps performed at our hospital since September 2009. Read More

Plast Reconstr Surg 2019 01;143(1):181-182

Saint John, New Brunswick, Canada From Dalhousie University.

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Dec;32(12):1545-1548

Department of Hand Surgery, Repair and Reconstruction Surgery, the Second Hospital of Tangshan (the Affiliated Hospital of North China Polytechnic University), Tangshan Hebei, 063000, P.R.China.

Objective: To investigate the effectiveness of Ilizarov technique in reconstruction of thumb function in patients with thumb degloving injury after amputation.

Methods: Between June 2011 and September 2016, 9 cases of thumb degloving injury were treated with amputation and Ilizarov technology. There were 8 males and 1 female with an age of 18-52 years (mean, 34. Read More

Microsurgery 2018 Nov 29. Epub 2018 Nov 29.

Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Thumb reconstruction has been a very challenging issue for hand surgeons. In this report, we present a case of thumb reconstruction with combination of the wrap-around flap prefabricated by the medialis pedis perforator flap with phalanx and nail bed banked from the amputated thumb. A 22-year-old man suffered from the left thumb amputation as well as large soft tissue defect of hand and comminuted fracture in wrist due to a crush accident. Read More

J Hand Microsurg 2018 Dec 5;10(3):162-165. Epub 2018 Apr 5.

Division of Plastic Surgery, University of Colorado, Aurora, Colorado, United States.

A right-hand-dominant 55-year-old male automotive mechanic presented 24 hours following a hydrofluoric acid burn to the volar left thumb. Despite the severity of soft tissue injury, the neurovascular bundles were intact. Although a free toe-pulp flap is often described to cover volar digit defects, the resultant 6- × 4-cm full-thickness injury of the thumb was too large to be adequately covered by a toe-pulp flap or other commonly used local flaps from the ipsilateral hand. Read More

J Hand Microsurg 2018 Dec 20;10(3):125-129. Epub 2018 Mar 20.

Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan.

Although dorsal subluxation is a typical finding for osteoarthritis of the thumb carpometacarpal (CMC) joint, it is difficult to evaluate the subluxation after trapeziectomy and the significance of its surgical correction combined with trapeziectomy is still controversial. The purpose of this study was to develop a method to evaluate dorsal subluxation without using landmarks on the trapezium. Thirty patients with thumb CMC arthritis and 13 normal patients were included in this study. Read More

Orthop Clin North Am 2019 Jan;50(1):87-93

Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee-Campbell Clinic, 1211 Union Avenue, Suite 510, Memphis, TN 38104, USA. Electronic address:

In the field of upper extremity surgery there are myriad new and developing technologies. The purpose of this article is to highlight a few of the most compelling new technologies and review their background, indications for use, and most recently reported outcomes in clinical practice. Read More

Ann Plast Surg 2019 Jan;82(1S Suppl 1):S13-S17

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.

Background: In this study, we present the long-term functional and aesthetic outcomes in patients with complicated asymmetric radial polydactyly treated with this surgical technique involving the transposition of a duplicated thumb.

Methods: We evaluated 6 thumbs in 6 patients who underwent radial polydactyly reconstruction using the transposition of duplicated thumb procedure between 2001 and 2017. The procedure was used when one of the thumbs was not obviously dominant over the other, with one having a better proximal portion and the other having a better distal portion. Read More

J Plast Surg Hand Surg 2018 Dec 16;52(6):359-362. Epub 2018 Nov 16.

a Department of Orthopaedic Surgery , Nara Medical University , Kashihara , Japan.

Objective: Toe-to-hand transplantation is a reliable procedure that replaces like-with-like in cases of a lost thumb or finger. The aim of this study is to investigate the effects of toe transplantation on patients from the perspectives of quality of life (QOL) and disability.

Methods: Ten patients with traumatic amputation of a digit underwent reconstruction with toe transplantation. Read More

J Hand Surg Asian Pac Vol 2018 Dec;23(4):469-473

† School of Medicine, Deakin University, Waurn Ponds, Geelong, Australia.

Background: To assess the midterm outcome of patients under 65 who underwent anatomic pyrocarbon hemiarthroplasty for thumb carpometacarpal (CMC) osteoarthritis.

Methods: A prospective analysis was performed of a consecutive series of active patients, less than 65 years of age, with symptomatic osteoarthritis who had undergone a CMC hemiarthroplasty using a stemmed metacarpal based, anatomic pyrolytic carbon resurfacing with an additional one third flexor carpi radialis (FCR) tendon transfer to maintain stability. The Wrightington Hand Score, Disability Arm Shoulder and Hand (DASH) Score, and the Patient Rated Wrist Evaluation Score (PRWE) were utilised. Read More

J Hand Surg Asian Pac Vol 2018 Dec;23(4):515-519

‖ Centro Médico Imbanaco de Cali S.A, Cali, Colombia.

Background: Pellegrini's surgical technique is the most useful for thumb carpometacarpal joint osteoarthritis. The purpose of this paper is to describe the technique of a modified version using a bone block in the tunnel through which the flexor carpi radialis tendon is passed (BBTI).

Methods: Case series of patients diagnosed with osteoarthritis of the thumb carpometacarpal joint, in stage II or higher based on Eaton's classification, that were intervened using the BBTI technique for a 2-year period. Read More

J Hand Surg Am 2019 Jan 23;44(1):9-17. Epub 2018 Oct 23.

Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão, SC, Brazil.

Purpose: With ulnar nerve injuries, paralysis of the first dorsal interosseous (FDI) and the adductor pollicis (ADP) muscles weakens pinch. The likelihood that these muscles will be reinnervated following ulnar nerve repair around the elbow is very low. To overcome this obstacle, we propose a more distal repair: transferring the opponens pollicis motor branch (OPB) to the terminal division of the deep branch of the ulnar nerve (TDDBUN). Read More

J Spinal Cord Med 2018 Oct 23:1-8. Epub 2018 Oct 23.

b Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.

Context/objective: Spinal cord injury (SCI) causes atrophy of brain regions linked to motor function. We aimed to estimate cortical thickness in brain regions that control surgically restored limb movement in individuals with tetraplegia.

Design: Cross-sectional study. Read More

J Wrist Surg 2018 Nov 2;7(5):394-398. Epub 2018 Jul 2.

Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

 Proximal migration of the first metacarpal can be seen after total trapeziectomy and various techniques have been described to prevent this subsidence.  We hypothesized the insertion of a poly-L/D-lactide spacer to prevent proximal migration of the first metacarpal without the need of an additional ligament reconstruction, allowing early mobilization and less demanding rehabilitation.  Ten thumbs were treated with a total trapeziectomy and insertion of a poly-L/D-lactide scaffold. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(2):130-136

Ortopedické oddělení, Karvinská Hornická Nemocnice, a.s., Karviná - Nové Město.

PURPOSE OF THE STUDY Trapeziometacarpal osteoarthritis affects primarily postmenopausal middle-aged and older women. Total joint replacement is one of the surgical treatment options for symptomatic advanced degenerative changes of the carpometacarpal joint. This study aims to evaluate the short-term functional and radiological results of the Ivory ® prosthesis with the minimum followup period of three years after the surgery. Read More

Acta Chir Orthop Traumatol Cech 2018 ;85(2):125-129

Ortopedické oddělení Nemocnice v Chomutově, Krajská zdravotní, a.s., Chomutov.

PURPOSE OF THE STUDY The aim of the study was to present the surgical technique combining the interposition and suspension arthroplasty using the TIE-IN implant as a treatment option for advanced symptomatic to final stage rhizarthrosis. MATERIAL AND METHODS Since 2015 we have performed the interposition arthroplasty combined with suspension arthroplasty using the TIE-IN implant in 12 patients, mostly indicated for stage IV rhizarthrosis. In two cases stage III rhizarthrosis with concomitant trapezium destruction was present. Read More

J Hand Surg Am 2018 Oct 3. Epub 2018 Oct 3.

Department of Plastic Surgery, Yale School of Medicine, New Haven, CT.

Purpose: Traumatic amputations of the thumb are rare in children compared with adults, but hand surgeons remain reticent to consider microsurgical reconstruction with toe-to-thumb transfers. This study reports the functional outcomes and complications of children with traumatic thumb amputations who underwent toe-to-thumb reconstruction.

Methods: A retrospective review of children who sustained thumb amputations and whose parents elected for their child to undergo reconstruction by toe-to-thumb transfer was performed. Read More

Mod Rheumatol 2018 Oct 4:1-15. Epub 2018 Oct 4.

a Department of Orthopedic Surgery , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Japan.

Objectives: The aim of the current study was to investigate the pattern of extensor pollicis brevis (EPB) insertion macroscopically and histologically using cadaveric thumbs, and to compare the incidence of different insertions with that of thumb boutonnière deformity in rheumatoid arthritis (RA) patients who required surgical reconstruction.

Methods: We examined 103 thumbs of 58 adult cadavers with no evidence of RA, and reviewed the surgical records of 28 thumbs of 23 RA patients who underwent surgical reconstruction for thumb boutonnière deformity. The incidence of different insertion patterns of the cadaveric thumbs and the RA thumbs were compared using the Fisher's exact test. Read More

J Hand Surg Asian Pac Vol 2018 Sep;23(3):408-411

* Department of Orthopaedic Surgery, Tsuchiura Kyodo Hospital, Tsuchiura, Japan.

A 15-year-old male patient presented with difficulty extending his right thumb due to subluxation of the extensor pollicis longus (EPL) tendon. Physical examination showed that active motion of the thumb's metacarpophalangeal (MP) joint was 76° in flexion and -58° in extension. During active extension, the EPL tendon shifted onto the ulnar aspect of the MP joint, and the extensor pollicis brevis (EPB) tendon shifted onto the central dorsal course of the MP joint. Read More

J Bone Joint Surg Am 2018 Oct;100(19):e127

Philadelphia Hand to Shoulder Center, Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.

Background: Although orthopaedic surgeons have been shown to prescribe excessive amounts of opioid analgesics postoperatively, the degree in which surgical trainees contribute to this trend is unknown. The purpose of this study was to compare self-reported opioid-prescribing behavior, factors influencing this behavior, and perceptions of patient opioid utilization and disposal between hand surgeons and trainees.

Methods: Attending hand surgeons and trainees in hand, orthopaedic, and plastic surgery programs were invited to participate in a web-based survey including demographic characteristics; self-reported prescribing behavior specific to 4 procedures: open carpal tunnel release, trigger finger release, thumb carpometacarpal arthroplasty, and distal radial fracture open reduction and internal fixation; and perceptions and influencing factors. Read More

J Hand Surg Eur Vol 2019 Jan 17;44(1):69-79. Epub 2018 Sep 17.

1 Department of Plastic, Reconstructive and Hand Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.

Triphalangeal thumb is a rare congenital anomaly in which the thumb has three phalanges. Clinical presentation of triphalangeal thumb can vary considerably and can be present in both hands or unilateral. The thumb can be long with a finger-like appearance. Read More

Pol Przegl Chir 2018 May;90(4):1-5

Uniwersytet Medyczny w Gdańsku Katedra i Klinika Ortopedii i Traumatologii Narządu Ruchu.

The paper summarizes 32 months (January 2014 - August 2016) of activity of the Replantation Service for hand amputation in Poland. Over this period a total of 568 cases of total and subtotal amputations as well as other complex injuries to the hand were referred. Of these, 354 referrals (62%) were accepted and 214 (38%) rejected. Read More

Eplasty 2018 13;18:ic15. Epub 2018 Aug 13.

Division of Plastic Surgery, Department of Surgery, Rutgers University/New Jersey Medical School, Newark.

J Hand Surg Eur Vol 2019 Jan 22;44(1):15-24. Epub 2018 Aug 22.

3 Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, Sydney.

The reconstruction of a congenital hypoplastic thumb usually involves release of a tight first web space, metacarpophalangeal joint stabilization, reconstruction of intrinsic muscle function, and extrinsic tendon reconstruction, as appropriate. Numerous surgical options and combinations are available, but the approaches vary among surgeons who work in the field of congenital hand surgery and the empirical evidence that allows for evaluation of the results of techniques is scarce. Both the pre-operative assessment and intra-operative findings of all thumb elements - bone, joints, and soft tissues - should be considered in the surgical decision-making and eventually define the methods of reconstruction. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 09;32(9):1201-1204

Department of Pediatric Orthopaedics, Wuxi No.9 People's Hospital Affiliated to Soochow University, the Orthopaedic Hospital of Wuxi, Wuxi Jiangsu, 214000,

Objective: To explore the effectiveness of anterograde fascial flap of digital artery in reconstruction of Wassel Ⅳ-D thumb duplication.

Methods: Twelve cases of Wassel Ⅳ-D thumb duplication were treated with anterograde fascial flap of digital artery between June 2014 and March 2017. There were 7 boys and 5 girls with an age of 9-32 months (mean, 13. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 09;32(10):1317-1320

Department of Pediatric Orthopaedic, Wuxi No.9 People's Hospital Affiliated to Soochow University, the Orthopaedic Hospital of Wuxi, Wuxi Jiangsu, 214000, P.R.China.

Objective: To investigate the diagnosis and treatment of thumb polydactyly with symphalangism in children.

Methods: Seven cases of thumb polydactyly with symphalangism were treated between January 2013 and May 2017. There were 5 males and 2 females, aged from 10 months to 11 years, with an average age of 3. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Jul;32(7):827-831

Department of Hand and Plastic Surgery, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou Zhejiang, 325027, P.R.China.

Surgery is still the main treatment for congenital polydactyly, and the aim of surgical reconstruction is to obtain a thumb with excellent function and appearance. A systematic assessment of polydactyly is required prior to surgery, including bone stress lines, joint deviation, joint activity and joint instability, size and development of finger and nail. Bone shape, joint incongruency, and abnormal tendon insertions must be corrected completely, in order to obtain good function and to avoide secondary surgery. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018 Jul;32(7):798-802

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233,

The replantation of amputated finger (or limb) and the reconstruction of the thumb and fingers started in 1960s in China. With the development of microsurgical techniques, both finger replantation and reconstruction achieved worldwide significant success. And now it is not the survival rate but the function of replanted finger that attracted more attention. Read More

Acta Neurochir (Wien) 2018 Oct 9;160(10):2019-2023. Epub 2018 Aug 9.

Neuroscience Research Center, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Objective: Injuries of the upper trunk of the brachial plexus may trigger motor and sensory deficits. There exists a growing body of literature with respect to the reconstruction of motor deficits in upper trunk brachial plexus injuries by using nerve transfers; albeit to date, very few old reports have focused on the reconstruction of sensory loss resulting from upper trunk injuries. In this case series, we review six cases (five males and one female) with upper trunk brachial plexus injuries undergoing sensory nerve transfers. Read More

World J Plast Surg 2018 May;7(2):151-158

Plastic, Reconstructive Surgery and Burns Department, Tanta Faculty of Medicine, Tanta, Egypt.

Background: Reconstruction of complex soft tissue defects of the thumb, with exposure of tendons, joints or bones, has always been a difficult task. We evaluated the functional and esthetic outcomes of 1 dorsal metacarpal artery island flap in reconstruction of post-traumatic soft tissue defects of the thumb.

Methods: Between January 2012 and June 2014, fifteen patients with complex post-traumatic soft tissue thumb defects underwent 1 dorsal metacarpal artery island flap. Read More