Abstract
Introduction Wrap-around procedure was introduced by Morrison and now it has full acceptation as a technique of thumb reconstruction associated with preservation of MP joint. Author presents: indications for this procedure, determination of flap diameters, bone graft and selection of dominant vessel leading to the great toe by arteriography. Aim of the study The end functional results of hand and foot after wrap-around flap procedure. Material and method 15 cases were analysed (follow-up 2–5 years) to present the functional outcomes.
Hand – the stability and MP motion in 14 case were satisfied. The sensibility, except one case, in 2 points discrimination test was between 14 mm – 20 mm. Pinch and grasp reached 40–60% of hand’s opposite site. Remodelling processes were satisfactory except one case of limited bone graft resorption which required supporting by cancellous bone.
Foot – function of the foot was outlined by podoscope and pedobarography (before and after operation). Podograms in all cases revealed limited deficits in loading pulp of toe. Pedobarograms in 6 cases revealed lateralised trajectory of loading. In these cases there were no chance to weight-bear of forefoot. In the rest cases only deficits in loading surface of the toe’s tip were presented on pedobarograms. The notices to vascular complications like twisting pedicle, constriction by tight skin closure or kinking pedicle were mentioned too. Conclusions The wrap-around procedure is good and sure method in reconstructions of adult’s thumb deficits.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
