Thumb reconstruction by the wrap-around method
Nunley, J.A.; Goldner, R.D.; Urbaniak, J.R.
Clinical Orthopaedics and Related Research 195: 97-103
1985
ISSN/ISBN: 0009-921X PMID: 3884213 Document Number: 257818
Reconstruction of a thumb amputated distal to the metacarpophalangeal joint can be accomplished by the "wrap-around" procedure. The operative procedure calls for an iliac crest graft to replace the bone of the amputated thumb. A flap from the great toe with innervation and circulation intact, including the toenail as well as sensory nerve, is wrapped around an iliac crest graft in a single-stage reconstruction of the thumb. This procedure allows a nice aesthetic result; the nail is transferred, sensibility is restored to the amputated thumb through the transferred neurovascularly intact flap, and the procedure is done at a single sitting. Results to date have been excellent in ten patients.