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Key Principles of Staged Combined Reconstruction of Fingers

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Author(s): N.М. Alexandrov | S.V. Petrov | E.V. Bashkalina | D.V. Kiselev | M.S. Petrov

Journal: Sovremennye Tehnologii v Medicine
ISSN 2076-4243

Volume: 5;
Issue: 1;
Start page: 97;
Date: 2013;
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Keywords: Finger reconstruction | Lipocutaneous pedicle flap grafting | Osteocutaneous flap transfer by microvascular anastomosis | The second toe transfer by microvascular anastomosis | Transplantation of osteocutaneous radial flap

ABSTRACT
The aim of the investigation was to develop the technique of staged reconstruction of the lost fingers and repair of hand soft tissue defects using high-precision and standard surgical procedures.Materials and Methods. We performed primary and secondary reconstruction of digits using a non-free flap plasty in combination with osteocutaneous grafting and their transposition by microvascular anastomosis in 41 patients with mechanical (29), thermal (8) and gunshot (4) hand injuries. Hand and forearm vessel examinations included clinical, radiological, biomechanical, reovasographic, anatomic and ultrasound investigations.Results. Complete acceptance of osteocutaneous transplants was recorded in 92.8% patients. Lipocutaneous grafts were accepted in all patients. Handgrip was recovered in 75% patients, and hand function improvement was achieved in all patients. Radiological and morphological investigations revealed insignificant resorption in the distal segment of the bone graft, it being mostly expressed in cases of osteocutaneous radial flap grafting.Conclusions. The developed technique ofreconstruction of fingers helps to recover an adequate handgrip function with minimal donor defects in patients with the most severe injuries as a result of mechanical, thermal or gunshot traumas.
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