Spare Parts Surgery with a Free Posterior Interosseous Artery Perforator Flap for Thumb Tip
| Autor: | Kan Nakamoto, Yosuke Niimi, Masami Murakami, Wataru Kamei, Nagisa Osa, Hiroyuki Sakurai |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
RD1-811 medicine.medical_treatment Case Report 030230 surgery Thumb 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Deformity Hand/Peripheral Nerve Brachial plexus block integumentary system business.industry Cutaneous nerve Nail plate Posterior interosseous artery Surgery body regions medicine.anatomical_structure Amputation 030220 oncology & carcinogenesis Replantation medicine.symptom business |
| Zdroj: | Plastic and Reconstructive Surgery Global Open Plastic and Reconstructive Surgery, Global Open, Vol 9, Iss 6, p e3624 (2021) |
| ISSN: | 2169-7574 |
| Popis: | Summary:. Replantation is an ideal method for treating fingertip amputation. However, in some cases, replantation is known to be a challenging issue. This report described a successful thumb tip reconstruction performed with bone and nail bed salvaged as spare parts, and a free posterior interosseous artery perforator (PIAP) flap. A 75-year-old man accidentally amputated his left thumb with an electric saw, and emergency replantation was started under brachial plexus block. However, the distal stump of digital artery was unable to be identified, forcing the initial plan to change to flap reconstruction. After vascular anastomosis, complex tissue containing nail bed and side nail fold was grafted on the adipofascial tissue of PIAP flap. Both PIAP flap and the complex tissue survived completely. At 12 months after surgery, only a slight deformity in the nail plate was observed. Spare parts surgery is a surgical procedure effectively salvaging and utilizing tissue that is going to be discarded in severe limb trauma. This idea can be applied to treatment for the finger amputation. In this case, replantation would be difficult in the thumb tip amputation, so spare parts surgery was performed with a PIAP flap. The innervated PIAP flap is reported, including the posterior antebrachial cutaneous nerve. In this case, the cutaneous nerve was able to be identified, neurorrhaphy was performed, and sufficient sensory recovery was obtained. Surgical procedure with PIAP flaps was found to be a useful method for immediate reconstruction with salvaged spare parts after fingertip replantation was considered to be difficult intraoperatively. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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