Distraction Lengthening of the Thumb Following Replantation

ABSTRACT

Distraction lengthening is one of several surgical reconstructive methods used to obtain length of an amputated digit and to improve function. However, the use of this technique following replantation is a relatively new concept. A case of a 32-year-old male who sustained a traumatic amputation of his left nondominant thumb and index finger is described. The injury and the replantation surgery each resulted in a significant amount of bone loss from the thumb. Nine months following the replantation, distraction osteogenesis was utilized to lengthen the thumb and to improve both function and cosmesis.

KEYWORDS

Distraction lengthening - thumb amputation - replantation

REFERENCES

• 1 Emerson E, Krizek T, Greenwald D. Anatomy, physiology, and functional restoration of the thumb.  Ann Plast Surg. 1996;  36 180-191
• 2 Littler J W. On making a thumb.  J Hand Surg. 1976;  1A 35-51
• 3 Heitmann C, Levin L. Alternatives to thumb replantation.  Plast Reconstr Surg. 2002;  110 1492-1503
• 4 Bouletreau P, Warren S, Longaker M. The molecular biology of distraction osteogenesis.  J Cranio-Maxillofacial Surg. 2002;  30 1-11
• 5 Matev I B. Thumb reconstruction through metacarpal bone lengthening.  J Hand Surg. 1980;  5 482-487
• 6 Skoulis T, Vekris M, Terzis J. Effect of distraction osteogenesis on the peripheral nerve: experimental study in the rat.  J Reconstr Microsurg. 1998;  14 565-574
• 7 Heitmann C, Levin L. Distraction lengthening of thumb metacarpal.  J Hand Surg. 2004;  29B 71-75
• 8 Nisanci M, Er E, Yildiz C, Turegun M, Atealp S, Sengezer M. Replantation of a crush amputation of distal tibia followed by lengthening with Ilizarov circular external fixator: two-year follow up.  Microsurgery. 2002;  22 295-299
• 9 Brooks D, Buncke G, Buncke H. Distraction osteogenesis after toe-to-thumb transplantation.  Plast Reconstr Surg. 2002;  109 2434-2438
• 10 Vekris M, Bates M, Terzis J. Optimal time for distraction osteogenesis in limbs with nerve repairs: experimental study in the rat.  J Reconstr Microsurg. 1999;  15 191-201
• 11 Papakonstantinou K, Shiamishis G, Bates M, Terzis J. Distraction osteogenesis using IGF-I after nerve microreconstruction.  J Reconstr Microsurg. 2002;  18 401-410