Reconstruction of thumb IV degree defect

Suitable for thumb IV degree defects. Treatment of diseases: hand injury, thumb metacarpophalangeal joint ulnar collateral ligament injury Indication Suitable for thumb IV degree defects. Preoperative preparation 1. Establish a good relationship between nurses and patients. Respect each other and trust each other. 2, adjustment support system patients often have some worries after hospitalization, such as worry about the economic burden, worry about work problems, worry about how others see their own re-creation of fingers and other caregivers should try to get the encouragement and support of family members and colleagues to receive treatment. 3. Creating a good environment for a good medical environment is important for normal people. It is more important for patients. A quiet and clean environment is conducive to calming the patient's mood. Watching TV, listening to music, walking outdoors and other activities can distract the patient's attention and reduce the patient's psychological burden. 4, the use of cognitive therapy cognitive therapy is through the interaction between the nurse and the patient through the communication to make the patient understand the meaning of the conversation related to the common sense of the patient to answer the various concerns of the patient to re-recognize it to let go of the mind Various burdens. Surgical procedure The second toe with the metatarsophalangeal joint was selected to reconstruct the thumb. In the case of mild stenosis of the thumb, the second toe with the rudder-like dorsal flap was used to reconstruct the thumb of the contralateral defect. Provide the back side incision design. Provide an ankle-side incision design. The toes, the back and the saphenous vein were separated, and the branches of the ligature were cut and released to the great saphenous vein. The dorsal artery and accompanying vein are found far beyond the ligament, and are separated distally to the metatarsophalangeal joint. The high position cuts the shortness of the thumb. Find the deep branch of the foot that continues with the dorsal artery of the foot and the first dorsal sacral artery from the deep branch. The dorsal interosseous muscle was isolated and separated to the distal end along the first dorsal artery. The first dorsal iliac artery is protected from the dorsal metatarsal and dorsal artery of the second toe. The toe and toe base artery of the toe of the big toe was cut and ligated. The skin was cut at the second and third toe tendons, and the second and third interphalangeal arteries were separated and ligated. Cut the transverse ligaments of the two metatarsal bones. The bilateral toe nerves were separated on the temporal side, the tendon sheath was cut, and the toe flexor tendon was picked out, all of which were cut at a high position. The toe length and short extensor tendon were cut at the high side of the dorsal side, and the dorsal and temporal interosseous muscles connected to the second toe were cut. The periosteum was peeled off 1.5 cm proximal to the second metatarsal head, and the second metatarsal bone was cut with a wire saw. At this time, except for the dorsal artery of the foot and the large vein, the rest of the tissue has been disconnected. The dorsal side of the thumb is a sagittal incision. Separate the finger nerves, loosen the thumb length, short extensor tendon, and flexor hallucis longus. Find the part of the tendon of the thumb short abductor. A transverse incision was made at the anatomic snuff. The cephalic vein was freed and the iliac artery was separated deep in the ulnar side of the flexor hallucis longus. The dorsal artery of the second toe and the saphenous vein were broken at a high position. Move the second toe to the receiving area. The wound in the donor area is directly sutured. The distal and proximal bone ends were repaired again, and the inner membrane was fixed with a steel wire, and the periosteum was sutured. The long toe and short extensor tendon are combined with the long and extensor tendon; the long flexor tendon is sutured with the flexor hallucis longus; the tendon of the buckling flexor tendon is sutured with the tendon of the second toe and the tendon of the interosseous muscle. Reconstruct the function of the thumb to the palm. The second metatarsophalangeal joint tarsal plate was sutured with the first metacarpal periosteum to correct the overextension of the metatarsophalangeal joint. Sew the bilateral toe fingers. The dorsal artery of the foot and the saphenous vein were anastomosed to the radial artery and cephalic vein of the anatomical nasal cavity through a subcutaneous tunnel to reconstruct the blood circulation of the thumb. Reconstruct the thumb palm side view. Reconstruct the back of the thumb.

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