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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Origami Medial Femoral Condyle Flap for Finger Joint Reconstruction

Meeting Abstract

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  • presenting/speaker Hiroki Hachisuka - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Norikazu Hamada - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Shoji Shimose - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Takahiko Hamasaki - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Yasunori Izuta - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Jun Fujimori - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Ryo Mori - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Shingo Okawa - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan
  • Shigeki Ishibashi - Kure Medical Center, Chu-goku Cancer Center, Kure, Hiroshima, Japan

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. DocIFSSH19-66

doi: 10.3205/19ifssh1012, urn:nbn:de:0183-19ifssh10129

Veröffentlicht: 6. Februar 2020

© 2020 Hachisuka 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: Finger joint reconstruction is challenging for hand surgeons, especially when accompanied by severe soft tissue damage. Accordingly, we adopted use of a vascularized medial femoral condyle (MFC) flap. In our procedure, a finger joint is fabricated with origami-like folding of vascularized periosteum. We report our experience with this origami MFC flap for finger joint reconstruction.

Methods: Four woman and two men underwent finger joint reconstruction with an origami MFC flap. The affected joints were as follows: two metacarpophalangeal (MCP), one thumb interphalangeal (IP), and three proximal interphalangeal (PIP) joints. The mean age of the patients was 52. Original diagnosis of the patients was benign bone tumor in distal phalanx of the right thumb, incomplete amputation of left ring finger, and septic arthritis in the left middle finger. The mean follow-up period was 40 months. Two cases lost hemi-articular surfaces in each joint, and another four cases lost a bilateral articular surface, complicated with loss of soft tissues; skin, subcutaneous tissue, such as ligament, volar plate, and tendon attachment. The mean follow-up period was one year (six months to five years).

The results of surgery were evaluated retrospectively based on clinical course, plain X-rays, range of motion (ROM), functional Disability of the Arm, Shoulder and Hand (DASH) score, pinching power, and complications at the donor site.

Results and Conclusions: Joint spaces and joint function were maintained in all cases. Average ROM was 49° (range four to 100). Pinching power was achieved in 100% of the non-affected side in all cases. The average DASH score was 5.8 (range 0 to 21), and all patients returned to their original work, including heavy manual labor. No cases had complications at the donor site.

An origami MFC flap can reconstruct a functional IP joint with motion and stability. Donor site complications are minimal in this procedure. This procedure can be a solution in finger joint reconstruction for adult patients.