Thumb and Finger Reconstruction
The application of 3D printing technology in comprehensive reconstruction of thumb and finger
HUANG Wei, XU Liang, CHENG Baoguo, DU Qiangqiang, ZHANG Shiguang, JIANG Baobin, WANG Xiaoli, LI Chusong, WANG Dongyue, TIAN Jiaxin
Published 2020-10-25
Cite as Chin J Microsurg, 2020, 43(5): 459-463. DOI: 10.3760/cma.j.cn441206-20200409-00192
Abstract
ObjectiveTo explore the application effect of 3D printing technology in comprehensive reconstruction of thumb and finger.
MethodsFrom January, 2018 to January, 2020, 67 patients with 84 thumbs and fingers defects were selected, which were 37 thumbs and 47 fingers, and 45 of I-III degree and 39 of IV-VI degree. The method of operation was comprehensive reconstruction of thumbs and fingers assisted by 3D printing technology. The patient's hands and feet were scanned with CT and 3D modeling, and the 1∶1 model was derived. The skin model and bone model of thumb and finger defect were printed. Put the skin model on the great toes, and design the shape of the nail flap to be cut. Then the flap was spread in the groin area to design the perforating branch flap of the superficial circumflex iliac artery. The interphalangeal joint or metatarsophalangeal joint of the second toe was cut off according to the skeleton model (when the length of the bone joint was not enough, the iliac bone strip was taken to be connected in series). The effect of operation was observed in outpatient.
ResultsAll of the 84 thumbs and fingers survived and were followed-up for 3 to 24 months. The appearance of the reconstructed thumbs and fingers was similar to that of the normal ones, with good texture and elasticity. The nail was smooth and glossy. The sensory recovery was S3+, and the TPD was 4-6 mm. According to the Evaluation Standard of Finger Replantation and Reconstruction of Hand Surgery Society of Chinese Medical Association, 70 thumbs and fingers were excellent and 14 thumbs and fingers were good. In 64 thumbs and fingers, all toes were preserved in the donor area, and the color and texture of the flap were satisfactory, which did not affect walking, running and jumping, and had no walking pain.
ConclusionWith the help of 3D printing technology, the tissues can be cut more accurately during the thumb and finger comprehensive reconstruction, which not only improves the beauty of reconstructed thumbs and fingers, but also avoids unnecessary trauma and improves the satisfaction of patients.
Key words:
Thumb defect; Finger defect; Comprehensive reconstruction; 3D printing; Hallux nail flap; Microsurgical technique
Contributor Information
HUANG Wei
Jinan Microsurgery Hospital, Jinan 250024, China
XU Liang
The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan 250031, China
CHENG Baoguo
Jinan Microsurgery Hospital, Jinan 250024, China
DU Qiangqiang
Jinan Microsurgery Hospital, Jinan 250024, China
ZHANG Shiguang
Jinan Microsurgery Hospital, Jinan 250024, China
JIANG Baobin
Jinan Microsurgery Hospital, Jinan 250024, China
WANG Xiaoli
Jinan Microsurgery Hospital, Jinan 250024, China
LI Chusong
Jinan Microsurgery Hospital, Jinan 250024, China
WANG Dongyue
Jinan Microsurgery Hospital, Jinan 250024, China
TIAN Jiaxin
Jinan Microsurgery Hospital, Jinan 250024, China
The Third Affiliated Hospital of Shandong First Medical University (Affiliated Hospital of Shandong Academy of Medical Sciences), Jinan 250031, China
趾上,设计需要切取的
甲瓣形状。按照骨关节模型截取第2足趾的趾骨间关节或跖趾关节（骨长度不够者取髂骨条串联）。门诊随访观察手术效果。
甲瓣
