eMedicine Specialties > Orthopedic Surgery > Hand & Upper Extremity

Thumb Reconstruction: Follow-up

Author: Reuben A Bueno, Jr, MD, Assistant Professor, Department of Surgery, Division of Plastic Surgery, Coordinator of Pediatric Plastic Surgery, Southern Illinois University School of Medicine; Consulting Staff, SIU Physicians and Surgeons, Inc
Coauthor(s): Bradon J Wilhelmi, MD, Endowed Leonard Weiner, MD, Professor and Chief of Division of Plastic Surgery, Residency Program Director, University of Louisville School of Medicine
Contributor Information and Disclosures

Updated: Nov 29, 2007

Outcome and Prognosis

As reported by Buncke and others, toe-to-hand transfer for thumb reconstruction can provide excellent end results and a high degree of patient satisfaction.35 The survival rate of these transfers has been reported to be as high as 98%, with 2-point discrimination of 8 mm or less in 80% of cases and, following reconstruction of the dominant thumb, a grip strength that is equal to 80% of the noninjured hand's grip strength.

In addition, most patients who have undergone toe-to-thumb transfer return to work and resume previous leisure activities, leading to a high degree of patient satisfaction. These findings are supported by Chung and Wei, who found better hand function in patients with toe-to-thumb transfer than they did in patients with a thumb amputation.36

In his review of index finger pollicizations employed to treat the congenital absence of a thumb, Manske found that patients had an average active range of motion of 98º in the pollicized digit (half the range of a normal thumb). He also determined that the average grip strength among these patients was 21% of normal grip strength and that their pinch strength ranged between 22% and 26% of normal pinch strength. Although these values are significantly lower than normal, they still indicate that index finger pollicization provides functional and aesthetic improvements over an absent thumb.37

 


More on Thumb Reconstruction

Overview: Thumb Reconstruction
Workup: Thumb Reconstruction
Treatment: Thumb Reconstruction
Follow-up: Thumb Reconstruction
Multimedia: Thumb Reconstruction
References
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References

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Further Reading

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Keywords

thumb injury, hand injury, toe-to-thumb transfer, toe to thumb transfer, thumb replantation, thumb reconstruction, osteoplastic thumb reconstruction, Moberg flap, Littler neurovascular island flap, kite flap, dorsal metacarpal artery flap, microvascular toe transfer flap, wraparound flap, toe-to-hand transfer, toe to hand transfer, phalangization, pollicization, pouce flottant thumb, Blauth type IV, Blauth type 4, congenitally absent thumb, Blauth type V, Blauth type 5, thumb amputation, toe amputation

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Contributor Information and Disclosures

Author

Reuben A Bueno, Jr, MD, Assistant Professor, Department of Surgery, Division of Plastic Surgery, Coordinator of Pediatric Plastic Surgery, Southern Illinois University School of Medicine; Consulting Staff, SIU Physicians and Surgeons, Inc
Reuben A Bueno, Jr, MD is a member of the following medical societies: American Association for Hand Surgery, American Society for Surgery of the Hand, and American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Bradon J Wilhelmi, MD, Endowed Leonard Weiner, MD, Professor and Chief of Division of Plastic Surgery, Residency Program Director, University of Louisville School of Medicine
Bradon J Wilhelmi, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Hand Surgery, American Association of Clinical Anatomists, American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Society for Surgery of the Hand, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, American Society of Reconstructive Microsurgery, Association for Surgical Education, Plastic Surgery Research Council, and Wound Healing Society
Disclosure: Nothing to disclose.

Medical Editor

Joseph E Sheppard, MD, Director of Hand and Upper Extremity, Associate Professor, Department of Orthopedic Surgery, University of Arizona
Joseph E Sheppard, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Society for Surgery of the Hand, Southern Orthopaedic Association, and Western Orthopaedic Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

N Ake Nystrom, MD, PhD, Associate Professor of Orthopedic Surgery and Plastic Surgery, University of Nebraska Medical Center
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD, Consulting Surgeon, Broward Hand Center, Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami School of Medicine
Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society
Disclosure: Nothing to disclose.

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