gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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First web-space commissure reconstruction with a precisely designed morphometric free flap

Meeting Abstract

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  • presenting/speaker Benjamin Smeeton - Department of Plastic & Reconstructive Surgery, St. Georges University Hospitals NHS Foundation Trust, London, United Kingdom
  • Dajiang Song - Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Central South University, Hunan, China
  • Pafitanis Georgios - Group for Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
  • Zhenglin Chi - Reparative and Reconstructive Microsurgery Center, Yunnan Zhongde Orthopaedic Hospital, Yunan, China
  • Peng Yang - Department of Orthopedic Surgery, The 455th Hospital of PLA, Shanghai, China
  • Xiao Zhou - Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Central South University, Hunan, China
  • Zan Li - Department of Oncology Plastic Surgery, Hunan Province Cancer Hospital, Central South University, Hunan, China
  • Mitsunaga Narushima - Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan
  • Isao Koshima - Department of Plastic and Reconstructive Surgery, International Center for Lymphedema, Hiroshima University, Hiroshima, Japan
  • Yixin Zhang - Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, Shanghai, China

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-467

doi: 10.3205/19ifssh0848, urn:nbn:de:0183-19ifssh08488

Veröffentlicht: 6. Februar 2020

© 2020 Smeeton et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: First web-space contractures have a significant impact on hand function by restricting thumb opposition and abduction. Surgical management utilizing non-standardized free flaps has been reported in the literature with often unpredictable outcomes. We sought to delineate the anthropometric morphological characteristics of first web-spaces derived from cadaveric dissections in an attempt to conceive a configuration algorithm for an individually-proportioned first web-space free flap design and harvest.

Methods: The morphological parameters of cadaveric first web-spaces were measured after pre-defining their cutaneous boundaries. Seven parameters measured from the patient's unaffected hand were selected to precisely calculate the dimensions, size and shape of the requisite free flap.

Results and Conclusions: Clinically, six cases of first web-space contracture were released and reconstructed with precisely designed morphometric free flaps. The appearance of the reconstructed first web-space aesthetically and functionally satisfied the patients. This study demonstrates the technique of precisely designing a patient-tailored first web-space commissure, utilising measurements from the patient's unaffected hand.