Download PDF
CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2021; 49(02): e160-e164
DOI: 10.1055/s-0041-1731769
Case Report | Relato de Caso

Reconstructive Principles for the Metacarpal Hand: Case Report

Article in several languages: English | español
Iker Miguel Escuredo
1   Plastic Aesthetic and Reconstructive Surgery Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
,
Guillermo Ibarrondo Arzua
1   Plastic Aesthetic and Reconstructive Surgery Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
,
Juan José García Gutierrez
1   Plastic Aesthetic and Reconstructive Surgery Department, Cruces University Hospital, Barakaldo, Bizkaia, Spain
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Metacarpal hand is one of the most devastating upper-extremity lesions. We report a case of a multidigit amputation corresponding to a Wei et al.[5] IA metacarpal hand in a 56 year-old-male. He underwent a sequential toe-to-hand transfer to the third and fourth radii. Reconstruction of the metacarpal hand, either in an acute or deferred presentation, must consider some reconstructive principles, including the identification of the structures to be spared and the coverage strategies for the acute stage. Toe-to-hand transfer is the preferred technique when replantation is not an option. It is critical to know which structures should be transferred to which positions, as well as to adapt the reconstructive plan to the characteristics from each patient.

Keywords

metacarpal hand - toe-to-hand - amputation


Publication History

Received: 20 April 2021

Accepted: 30 April 2021

Article published online:
13 December 2021

© 2021. SECMA Foundation. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 del Piñal F. Severe mutilating injuries to the hand: guidelines for organizing the chaos. J Plast Reconstr Aesthet Surg 2007; 60 (07) 816-827
    CrossrefPubMedGoogle Scholar
  • 2 Wallace CG, Wei FC. Posttraumatic finger reconstruction with microsurgical transplantation of toes. Hand Clin 2007; 23 (01) 117-128
    CrossrefPubMedGoogle Scholar
  • 3 Kokkoli E, Spyropoulou GA, Shih HS, Feng GM, Jeng SF. Heterotopic Procedures in Mutilating Hand Injuries: A Synopsis of Essential Reconstructive Tools. Plast Reconstr Surg 2015; 136 (05) 1015-1026
    CrossrefPubMedGoogle Scholar
  • 4 ALDeek NF, Lin YT, Wei FC. NF AL. Metacarpal-Like and Metacarpal Hand. Hand Clin 2016; 32 (04) 549-554
    CrossrefPubMedGoogle Scholar
  • 5 Wei FC, el-Gammal TA, Lin CH, Chuang CC, Chen HC, Chen SH. Metacarpal hand: classification and guidelines for microsurgical reconstruction with toe transfers. Plast Reconstr Surg 1997; 99 (01) 122-128
    CrossrefPubMedGoogle Scholar
  • 6 Wei FC, Lutz BS, Cheng SL, Chuang DC. Reconstruction of bilateral metacarpal hands with multiple-toe transplantations. Plast Reconstr Surg 1999; 104 (06) 1698-1704
    CrossrefPubMedGoogle Scholar
  • 7 Lin CH, Hu TL, Lin CH. Split second- and third-toe transplantation in mutilating-hand-injury reconstruction. Ann Plast Surg 2008; 60 (03) 267-271
    CrossrefPubMedGoogle Scholar
  • 8 Yim KK, Wei FC, Lin CH. A comparison between primary and secondary toe-to-hand transplantation. Plast Reconstr Surg 2004; 114 (01) 107-112
    CrossrefPubMedGoogle Scholar
  • 9 Woo SH, Kim JS, Seul JH. Immediate toe-to-hand transfer in acute hand injuries: overall results, compared with results for elective cases. Plast Reconstr Surg 2004; 113 (03) 882-892
    CrossrefPubMedGoogle Scholar
  • 10 Lin YT, Su ST, Lo S, Hu CH, Lin CH, Wei FC. Risk factors for reexploration in toe-to-hand transfer: a multivariate analysis of 363 cases. Plast Reconstr Surg 2015; 135 (02) 501-506
    CrossrefPubMedGoogle Scholar