IJOCP | April 2014 | Volume 1 | Issue 2 | Page 14 Conference: Poona Orthopaedic Society Annual Conference POSAC-2014, India[Click for Full details]
Purpose: To report a technique and result of “graft reposition on flap: a new reattachment procedure” for distal fingertip amputations in Allan type IV
Method:Reconstruction of six fingertip amputations by fixing the harvested bone to the proximal amputated stump of the distal phalanx with free nail bed graft (graft reposition) and flap cover. Depending upon its obliquity and loss of tissue author had replaced the pulp and exposed bone, either by a thenar flap or palmar V- Y advancement flap. Full thickness nail bed and bone (grafts) were harvested from amputated finger.It is based on and modification of the “reposition-flap” described by Foucher et al (1992.
Result: The length of the amputated fingertips was restored with bone and the flaps, and lost nailbeds were restored to their natural appearance with the free nailbed grafts. The results were classified as excellent, good, fair or poor according to the length of the reconstructed fingertip and the appearance of the nail unit. Four patients had sufficient healing and fingertip length to give good result and two cases had fair results. Author observed good results in Allen type IV fingertip amputations, but some shortening of the fingers due to bone resorption.
Conclusion: This technique is useful in Allen type IV fingertip amputation, where no nailbed and bone is discarded. There are some shortening of a finger, but no nail deformity and good pulp contour which makes it aesthetically, functionally and cosmetically pleasing. It is a good, useful alternative when replantation is impossible and not an option. This technique is best described as “graft reposition on flap” (GRF). Graft reposition on flap is a simple, easy, cost effective technique resulting in shorter time off work. The limitation of the current study is a small sample size and short follow up, but due to promising results, a large scale study and long follow up of ‘graft reposition on flap’(GRF) for Allen type IV fingertip amputations is required.
How to Cite this Abstract
Malshikre. To report a technique and result of “graft reposition on flap: a new reattachment procedure” for distal fingertip amputations in Allan type IV. I J Orthopaedic Conference Proceedings April 2014;1(2):14.