New progresses in thumb and finger reconstruction

Wang Zengtao; Liu Huanlong; Hao Liwen; Qiu Shenqiang; Liu Linfeng; Chen Chao

doi:10.3760/cma.j.cn501225-20240814-00305

Volume 41 Issue 2

Feb. 2025

Turn off MathJax

Article Contents

Abstract

References

Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2025 > 41(2): 109-119

Wang ZT,Liu HL,Hao LW,et al.New progresses in thumb and finger reconstruction[J].Chin J Burns Wounds,2025,41(2):109-119.DOI: 10.3760/cma.j.cn501225-20240814-00305.

Citation:

Wang ZT,Liu HL,Hao LW,et al.New progresses in thumb and finger reconstruction[J].Chin J Burns Wounds,2025,41(2):109-119.DOI: 10.3760/cma.j.cn501225-20240814-00305.

Citation:

Wang ZT,Liu HL,Hao LW,et al.New progresses in thumb and finger reconstruction[J].Chin J Burns Wounds,2025,41(2):109-119.DOI: 10.3760/cma.j.cn501225-20240814-00305.

PDF( 51592 KB)

New progresses in thumb and finger reconstruction

doi: 10.3760/cma.j.cn501225-20240814-00305

Department of Hand-foot and Microreconstructive Surgery, Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China

More Information

Corresponding author: Wang Zengtao, Email: wzt@sdu.edu.cn
Received Date: 2024-08-14

Abstract

Abstract

For centuries, people have been searching for ways to reconstruct the mutilated thumb and fingers. Among the hundreds of operation methods that have appeared, the method of toe transplantation to reconstruct the thumb and fingers, which appeared in the second half of the 19^th century, had the best effect. However, due to the limitation of technical level at that time, only the pedicled toe could be transplanted to reconstruct the thumb and fingers. During the treatment period, the patient was in an inappropriate position where the hand and foot were fixed together for a long time, and the nerve was not repaired, so the thumb and fingers reconstructed after surgery had poor feeling. Therefore, it has not been widely used. It was not until 1966 when Yang Dongyue succussed in reconstructing the thumb using a free toe transplant with blood vessel anastomosis that toe transplantation gradually became the mainstream method of thumb and finger reconstruction. The appearance and function of the thumb and finger reconstructed by toe transplantation are still very different from that of the normal thumb and finger. Moreover, when multiple thumbs and fingers are defective, the transplantation of multiple toes for repair will cause great damages to the foot, so it is not suitable to reconstruct more than three thumb and fingers using toes in the same period. In 2007, Wang Zengtao proposed the concept of "full-finger reconstruction of thumb and fingers" and a series of new operation methods: new fingers were designed and assembled by means of using a variety of tissue combination assembly, which changed the traditional method of toe transplantation to reconstruct thumb and fingers, and the method of replacing thumb and fingers by toes was changed to manufacturing new thumb and fingers so that the toes could be retained and the thumb and fingers could be reconstructed with approximately normal shape and function. In recent years, the concept and series of new operation methods of thumb and finger reconstruction have been popularized at home and abroad. This paper focuses on the development of full-finger reconstruction of thumb and fingers.
- Microsurgery,
- Surgical flaps,
- Thumb,
- Finger reconstruction,
- Full-finger reconstruction,
- Toes

FullText(HTML)

References(52)

References

[1]	程国良.手指再植与再造[M].2版.北京:人民卫生出版社,2005:5-6.
[2]	杨东岳,顾玉东,吴敏明,等.第二趾游离移植再造拇指40例报告[J].中华外科杂志,1977,15(1):13-18.
[3]	顾玉东,吴敏明,郑忆柳,等.足趾移植术中血管变异及其处理[J].解剖学杂志,1982,5(4):29-31.
[4]	顾玉东.足趾移植的回顾与展望[J].中华显微外科杂志,2000,23(1):10-11.DOI: 10.3760/cma.j.issn.1001-2036.2000.01.003.
[5]	顾玉东,吴敏明,郑忆柳,等.足趾移植术中血管的变异及其处理[J].中华外科杂志,1985,23(4):210-212.
[6]	CobbettJR.Free digital transfer. Report of a case of transfer of a great toe to replace an amputated thumb[J].J Bone Joint Surg Br,1969,51(4):677-679.
[7]	YuZJ,HeHG.Thumb reconstruction with free big toe skin-nail flap and bones, joints, and tendons of the second toe--report of the cases[J].Chin Med J (Engl),1985,98(12):863-867.
[8]	陈中伟,王琰.趾皮肤指甲瓣在再造拇指中的应用[J].中华外科杂志,1982,20(12):707-709.
[9]	于仲嘉,王琰.手缺损再造一例[J].中华医学杂志,1979,59(10):593-595.
[10]	于仲嘉,黄玉池.多指显微再造术[J].解剖与临床,2003,8(2):123-125.DOI: 10.3969/j.issn.1671-7163.2003.02.026.
[11]	于仲嘉,黄玉池.趾皮甲瓣和第二、三足趾联合移植再造拇、手指58例报告[J].实用手外科杂志,2001,15(2):73-75.DOI: 10.3969/j.issn.1671-2722.2001.02.002.
[12]	杨东岳,顾玉东,吴敏明,等.显微外科手术中血管问题的处理[J].中华外科杂志,1981,19(3):131-134.
[13]	陈中伟,王琰.足趾移植“再造手”[J].中华外科杂志,1981,19(1):7-9.
[14]	程国良,潘达德,林彬,等.急症拇指手指再造[J].解放军医学杂志,1984,9(1):30.
[15]	张涤生,王炜,吴晋宝.应用第二足趾、足背皮瓣(包括二者合并)修复手部缺损[J].上海医学,1979,2(5):10-14.
[16]	寿奎水,施海峰.一期修复全手脱套伤后的功能分析及最佳术式[J].中华手外科杂志,1999(1):23.DOI: 10.3760/cma.j.issn.1005-054X.1999.01.009.
[17]	寿奎水,张全荣,李向荣,等.亚急诊修复和再造拇、手指358例报告[J].中华手外科杂志,1995,11(4):204-206.DOI: 10.3760/cma.j.issn.1005-054X.1995.04.105.
[18]	王成琪.拇指创伤性截指后的再植与再造[J].前卫医药,1985(1):24.
[19]	王成琪,王剑利,王增涛,等.足趾移植再造拇指与手指常遇到的几个问题及处理[J].解放军医学杂志,2000,25(2):152-153.DOI: 10.3321/j.issn:0577-7402.2000.02.039.
[20]	范启申,王成琪,周建国,等.足趾移植再造手指464例[J].中华显微外科杂志,1997,20(3):186-188.DOI: 10.3760/cma.j.issn.1001-2036.1997.03.111.
[21]	芮永军,许亚军,张全荣,等.五块游离组织组合移植修复手脱套伤[J].中华显微外科杂志,2007,30(4):258-260.DOI: 10.3760/cma.j.issn.1001-2036.2007.04.011.
[22]	芮永军,寿奎水,许亚军,等.双侧多个足趾移植修复全手或多手指缺损[J].中华显微外科杂志,2008,31(3):166-168,后插一.DOI: 10.3760/cma.j.issn.1001-2036.2008.03.003.
[23]	芮永军,寿奎水,张全荣,等.四、五块游离组织组合移植一期手再造[J].中华手外科杂志,2003,19(4):223-225.DOI: 10.3760/cma.j.issn.1005-054X.2003.04.015.
[24]	方光荣,汤海萍,丁小珩,等.足趾移植多手指再造相关问题的探讨[J].中华手外科杂志,2011,27(1):20-23.DOI: 10.3760/cma.j.issn.1005-054X.2011.01.008.
[25]	丁小珩,方光荣,姜凯,等.全长手指再造10例报告[J].中华显微外科杂志,2008,31(3):163-165,后插一.DOI: 10.3760/cma.j.issn.1001-2036.2008.03.002.
[26]	程国良,方光荣,林彬,等.吻合趾指动静脉的拇指手指再造与修复[J].中华外科杂志,1994,32(2):79-81.
[27]	程国良,方光荣,侯书健,等.拇手指部分缺损的修饰性修复与重建[J].中华医学杂志,2005,85(38):2667-2673.DOI: 10.3760/j:issn:0376-2491.2005.38.002.
[28]	程国良.我国足趾移植拇手指再造与修复回顾与展望[J].中华手外科杂志,2007,23(2):65-68.DOI: 10.3760/cma.j.issn.1005-054X.2007.02.001.
[29]	GuYD,ZhangGM,ChengDS,et al.Free toe transfer for thumb and finger reconstruction in 300 cases[J].Plast Reconstr Surg,1993,91(4):693-700; discussion 701-702.
[30]	YuZ,HuangY.Sixty-four cases of thumb and finger reconstruction using transplantation of the big toe skin-nail flap combined with the second toe or the second and third toes[J].Plast Reconstr Surg,2000,106(2):335-341.DOI: 10.1097/00006534-200008000-00015.
[31]	BunckeHJJr,BunckeCM,SchulzWP.Immediate Nicoladoni procedure in the Rhesus monkey, or hallux-to-hand transplantation, utilising microminiature vascular anastomoses[J].Br J Plast Surg,1966,19(4):332-337.DOI: 10.1016/s0007-1226(66)80075-9.
[32]	WeiFC,ChenHC,ChuangCC,et al.Reconstruction of the thumb with a trimmed-toe transfer technique[J].Plast Reconstr Surg,1988,82(3):506-515.DOI: 10.1097/00006534-198809000-00025.
[33]	王增涛,蔡锦方,曹学成,等.趾腓侧皮瓣嵌入第二足趾改形法再造拇手指[J].中华手外科杂志,2002,18(1):20-22.DOI: 10.3760/cma.j.issn.1005-054X.2002.01.007.
[34]	ZhaoJ,TienHY,AbdullahS,et al.Aesthetic refinements in second toe-to-thumb transfer surgery[J].Plast Reconstr Surg,2010,126(6):2052-2059.DOI: 10.1097/PRS.0b013e3181f44994.
[35]	MorrisonWA,O'BrienBM,MacLeodAM.Thumb reconstruction with a free neurovascular wrap-around flap from the big toe[J].J Hand Surg Am,1980,5(6):575-583.DOI: 10.1016/s0363-5023(80)80110-9.
[36]	TsaiTM,AzizW.Toe-to-thumb transfer: a new technique[J].Plast Reconstr Surg,1991,88(1):149-153.DOI: 10.1097/00006534-199107000-00027.
[37]	KoshimaI,KawadaS,EtohH,et al.Free combined thin wrap-around flap with a second toe proximal interphalangeal joint transfer for reconstruction of the thumb[J].Plast Reconstr Surg,1995,96(5):1205-1210.DOI: 10.1097/00006534-199510000-00033.
[38]	PanYW,ZhangL,TianW,et al.Donor foot morbidity following modified wraparound flap for thumb reconstruction: a follow-up of 69 cases[J].J Hand Surg Am,2011,36(3):493-501.DOI: 10.1016/j.jhsa.2010.11.044.
[39]	ShenXF,MiJY,XueMY,et al.Modified great toe wraparound flap with preservation of plantar triangular flap for reconstruction of degloving injuries of the thumb and fingers: long-term follow-up[J].Plast Reconstr Surg,2016,138(1):155-163.DOI: 10.1097/PRS.0000000000002301.
[40]	ChiZ,SongDJ,TianL,et al.Reconstruction of combined thumb amputation at the metacarpal base level and index amputation at the metacarpal level with pollicization and bilateral double toe composite transfer[J].J Plast Reconstr Aesthet Surg,2017,70(8):1009-1016.DOI: 10.1016/j.bjps.2017.05.032.
[41]	SunW,ChenC,WangZ,et al.Full-length finger reconstruction for proximal amputation with expanded wraparound great toe flap and vascularized second toe joint[J].Ann Plast Surg,2016,77(5):539-546.DOI: 10.1097/SAP.0000000000000683.
[42]	王全胜,杨柳春,陈平,等.拇指缺损的全形再造[J].实用手外科杂志,2009,23(2):77-78.DOI: 10.3969/j.issn.1671-2722.2009.02.006.
[43]	刘刚义,程永冲,朱修文,等.拇指全形再造的临床体会[J].中华显微外科杂志,2013,36(3):241-244.DOI: 10.3760/cma.j.issn.1001-2036.2013.03.009.
[44]	孙文海长手指组合再造的应用解剖和数字化模型研究广州南方医科大学2016DOI:10.7666/d.Y3117237 孙文海.长手指组合再造的应用解剖和数字化模型研究[D].广州:南方医科大学,2016.DOI:10.7666/d.Y3117237.
[45]	ZangCW,ZhangJL,MengZZ,et al.3D printing technology in planning thumb reconstructions with second toe transplant[J].Orthop Surg,2017,9(2):215-220.DOI: 10.1111/os.12326.
[46]	王增涛.手指全形再造的重要意义[J].中华显微外科杂志,2011,34(4):265.DOI: 10.3760/cma.j.issn.1001-2036.2011.04.001.
[47]	王增涛,孙文海,仇申强,等.手指Ⅰ~Ⅲ度缺损的全形再造[J].中华显微外科杂志,2011,34(4):266-268.DOI: 10.3760/cma.j.issn.1001-2036.2011.04.002.
[48]	WangZT,SunWH.Cosmetic reconstruction of the digits in the hand by composite tissue grafting[J].Clin Plast Surg,2014,41(3):407-427.DOI: 10.1016/j.cps.2014.03.001.
[49]	王增涛,丁自海,邹继耀,等.趾趾尖移植再造手指指尖[J].中华显微外科杂志,2003,26(1):6-8.DOI: 10.3760/cma.j.issn.1001-2036.2003.01.002.
[50]	孙文海,王增涛,仇申强.手指Ⅳ~Ⅵ度缺损的全形再造[J].中华显微外科杂志,2011,34(4):269-271.DOI: 10.3760/cma.j.issn.1001-2036.2011.04.003.
[51]	王增涛,孙文海,仇申强,等.双侧趾甲骨皮瓣拼合移植术再造手指15例报告[J].山东医药,2010,50(18):104.DOI: 10.3969/j.issn.1002-266X.2010.18.062.
[52]	郝丽文,陈超,王增涛.骨延长技术在手指缺损全形再造中的应用效果观察[J].山东医药,2018,58(44):58-60.DOI: 10.3969/j.issn.1002-266X.2018.44.016.