Journals / Selçuk Tıp Dergisi / 2001 / Cilt: 17 - Sayı: 3
Reconstruction of both hands using pollicisation, tendon grafts and radial forearm flap in one stage
- Journal
- Selçuk Tıp Dergisi
- Pages
- 203–206
- DOI
- —
Abstract
A fifty two year old woman sustaining bilateral hand injurles after a traffic accident was admitted to our clinic. She had right thumb amputation from the carpometacarpal level, tendon and skin loss in the right hand second finger, loss of the 2-3 extensor tendons and the overlying dorsal skin in the left hand. Reconstruction in a single session was planned and palmaris longus tendons from both hands were taken and used as intercalary grafts for extensor tendon losses after which the skin loss was covered with a radial forearm flap. Afterwards, the second injured finger in the right hand was taken and pollicisized using the Buck Gramcko technique. At the last follow-up examination 8 months after the injury, she was able to pick up small objects and grip large and heavy objects using her right hand. The range of motion of the wrist and the fingers of the left hand was completely restored. The importance of treatment design tailored individually for each patient was stressed in this case.
Özet
Trafik kazasi sonrasi her iki el yaralanmasi ile klinigimize basvuran 52 yasindaki bayan hastada karpometakarpal seviyeden sag el basparmak amputasyonu, ayni el ikinci parmakta cilt ve tendon kaybi, sol el dorsalinde cilt ve 2-3. parmak ekstensör tendon kayiplari tespit edildi. Tek seansta rekonstrüksiyon planlanarak, sol elde palmaris longus tendonlarindan alinan greftler uygun gerginlikte ekstensör tendon kayiplarinin yerine interkalari greftler olarak tatbik edildi. Ardindan cilt defekti için ters akimli 'radial forearm flep' tasarlandi ve yara örtüldü. Takiben sag el ikinci parmak alinarak Buck-Gramcko'nun tarif ettigi teknikle basparmak yerine transfer edildi. Sekiz ay sonra yapilan kontrolde hastanin sag elini kullanarak küçük cisimleri tutabildigi, ayrica genis ve agir cisimleri kavrayarak kaldirabildigi görüldü. Sol elde ise bilek ve parmak hareket genislikleri tam olarak kazanilmisti. Klasik yoldan farkli tedavi edilen bu vakada tedavinin hastaya göre planlanmasi gerektigi bir kez daha vurgulandi.