Comparison On Effect Of Hallux Toenail Flap Combined With The Second Toe Bone Flap Transplantation And The Reshaped Second Toe Transplantation For Thumb Reconstruction

Objective To study clinical effect of hallux toenail flap combined with the second toe bone flap transplantation and the reshaped second toe transplantation for thumb reconstruction.Methods From January 2014 to June 2017,56 patients with Ⅱ ~ V degrees of thumb defection were randomly divided into two groups,the surgical approaches of hallux toenail flap combined with the second toe bone flap transplantation and the reshaped second toe transplantation for thumb reconstruction were used respectively.Fifty-two patients were followed up from 3 months to 3.5years after operation.Four patients were lost to follow-up.Results 56 thumbs all survived,the appearance of reconstructed thumbs was satisfactory,and the size and appearance of reconstructed thumbs used the surgical approaches of hallux toenail flap combined with the second toe bone flap transplantation were similar to the contralateral thumbs.The appearance of mid-section stenosis was significantly improved,with no expanse of finger pulp,and the appearance of reconstructed thumbs showed more realistic compared with the group of reshaped second toe transplantation.With the follow-up of 3 months to 3.5 years in 52 cases,function and sensory of the reconstructed thumbs recovered ideally,with normal walking,no claudication pain and with no other complications.According to the evaluation criteria for thumb and finger rebuilding function issued by Hand Surgery Branch of Chinese Medical Association.A total of 32 cases of excellent,10 cases of good,10 cases of fair were obtained,and the excellent and good rate was 81%.Conclusion The surgical approach of hallux toenail flap combined with the second toe bone flap transplantation for thumb reconstruction could solve multiple problems at one time,reduce the trauma and pain to patients,shorten the treatment cycle,accelerate the healing process,and was conducive to functional recovery,with more similar appearance to the normal thumb and higher satisfaction from patients.So the surgical approach technique is worth promoting.