标题：Donor Foot Morbidity Following Modified Wraparound Flap for Thumb Reconstruction: A Follow-Up of 69 Cases
作者：Pan, Yong-wei; Zhang, Lishan; Tian, Wen; Tian, Guanglei; Zhao, Junhui; Guo, Xianfeng
作者机构：[Pan, Yong-wei] Beijing Jishuitan Hosp, Dept Hand Surg, Beijing 100035, Peoples R China.; Beijing Jishuitan Hosp, Dept Rehabil, Beijing 100035, Peop 更多
通讯作者地址：[Pan, YW]Beijing Jishuitan Hosp, Dept Hand Surg, 31 Xinjiekou Dongjie, Beijing 100035, Peoples R China.
来源：JOURNAL OF HAND SURGERY-AMERICAN VOLUME
关键词：Foot morbidity; thumb reconstruction; wraparound flap
摘要：Purpose To evaluate donor foot morbidity after thumb reconstruction using a modified wraparound flap.; Methods We observed patients who accepted thumb reconstruction with the modified wraparound flap between January 2001 and December 2009. We examined and evaluated the reconstructed thumb and donor foot. Donor morbidity was assessed on both a subjective and an objective basis using the Foot Function Index verbal rating scales (FFI-5pt), the American Orthopaedic Foot and Ankle Society for Hallux Metatarsophalangeal-Interphalangeal (MTP-IP) scale, and gait analysis and dynamic pedodynographic measurements.; Results We reviewed 69 patients; the follow-up period ranged from 6 months to 5 years, with an average of 26 months. The reconstructed thumbs had good aesthetic appearance, and static 2-point discrimination averaged 9.4 +/- 2.7 mm. Full length or most of the length of the donor toes was preserved in 67 patients. The retained plantar strip was significantly enlarged from an average of 14.5 +/- 1.4 mm measured at surgery to 27.8 +/- 4.7 mm measured at last follow-up (p < .05), and its 2-point discrimination was 9.1 +/- 2.3 mm. A total of 34 patients were available for FFI-5pt and Hallux MTP-IP scale evaluation. The FFI-5pt total score was 3.1 +/- 2.7 and the total Hallux MTP-IP score was 87.9 +/- 7.1. Gait analysis and dynamic pedodynographic measurements were available in 20 patients. All 5 biomechanical parameters (timing, trajectory, symmetry, average peak force, and peak pressure between donor foot and the contralateral foot) had no significant difference.; Conclusions The function of the donor foot after a modified wraparound flap for thumb reconstruction was well preserved, the degree of pain and disability in the donor foot was mild, and foot function in gait was not disturbed. Although a certain degree of restriction in interphalangeal joint motion occurred, this was nearly negligible and did not deter return to normal daily living activity, work, and recreation. (J Hand Surg 2011;36A:493-501. Copyright (C) 2011 by the American Society for Surgery of the Hand. All rights reserved.)