Discuss your case We restore grip, sensation, support and movement after trauma, wounds and burns involving the fingers, tendons, nerves, soft tissue and bones of the hand or foot.
FIG. 09 / CONCEPTUAL VISUALIZATIONWrist and foot restorations are operations that restore grip, sensitivity, resistance and motion after injuries, wounds and burns.
Modern reconstructive surgery of the wrist and foot aims to restore anatomy, sensitivity and fine motor skills. The main principle is not simply closing a defect but restoring lost functionality, maintaining healthy blood supply and creating resilience.
They are called when a finger is lost or cannot be moved, the wrist numbness, wound does not close, bones have grown incorrectly, scars tighten toes or foot.
The specific indications, method and expected result are determined individually by the doctor after consultation and necessary examinations.
Six situations that are most common.
The thumb or index finger is absent, and the hand cannot grasp an object.
The thumb can be restored by transplanting the toe to the wrist with microsurgical suture of vessels and nerves. Other options are extension of the coccyx or transfer of an adjacent finger.
The finger is not bent or folded, and the hand is numb after the wound.
The tendon and nerve are sutured; if the ends do not come up without tension, the nerves defect is covered with an insert of your own nerver and the tendinitis - a graft. The nerving grows slowly so that sensation returns for months and not always completely.
A wound on the hand or foot does not close, leaving a tendon or bone exposed.
Small defects are covered with local flaps from adjacent fingers or wrists, larger - microsurgical flap from other parts of the body.
Deformation after fracture, pain and instability in the wrist, fifth or shoulder.
The bone is cut and placed in the correct position (osteotomia) on a virtual plan, fixed with plates; lost fragments are replaced by a graft or individual implant.
After custody or wounds, the fingers don't break, the foot is deformed by the scars.
Scar tissue is cut or excised, the lack of skin is covered with Z-plastics, grafts or flaps; after surgery — tires and rehabilitation.
The thumb of the foot is rejected, and there's a painful bone next to it.
Deformation redirects the osteottomy of the first humerus, open or low-invasive, through microcuts.
Key techniques used in hand and foot reconstruction.
These procedures account for most hand and foot reconstructions.
| Operation | When needed |
|---|---|
| The neck of the tendon and nerve | fresh injury, ends coming down without tension. |
| Nerve plastic with your own nerve | Nerve removal after wounds or scar removal |
| Local irons, Z-plastics | slight skin defects, fingertips |
| Osteosynthesis, osteottomy | Fractures and incredible bones |
This method is one of the main ways to repair polystructural damage, when skin, tendons, bones and nerves are simultaneously affected.
When reconstruction of the patient's own anatomy is not possible and amputation must be used, surgery prepares the coccyx for prosthetics: osteointegration (a titanium pin in the coxa) and targeted muscle reinervation against phantom pain.
The gold marks the tissue that the defects restore.
The big toe (often partially) or second toe is taken along with the vessels, nerves and tendons and transferred to the place of the thumb. Under a microscope, the blood vessel and nerve are sutured together. Walking after healing usually changes little but in some patients discomfort in the foot may be possible.
If the nerve ends do not rise without tension, a piece of your own sensitive nerves – for example from the shin or forearm – is sewn between them. The nerved fibers grow through the insert to the fingers.
The first bone is cut and moved so that the thumb becomes flat, and the “bone” shrunk. The bone can be fixed with screws; in a minimally invasive technique – through several millimetres of incisions.
The schemes are simplified and not scaled up.
Stop the bleeding with a tight bandage and call 911. Wrap your finger in gauze moistened with physiological solution or clean water, place it in a closed bag, then put the bag into a container of ice and water: do not let your Finger touch either ice or water.
Fresh tears are easier to sew; over time, ends are broken and plastic is needed.
When the wounds heal and the edema sleeps, the plan goes behind the C.T. and the examination.
When pain or deformation prevents walking and does not help orthopaedic shoes.
Terms depend on the number of transactions; the exact plan is individual.
After tendon surgery, the hand is kept in a splint for several weeks to protect the repair.
Rehab exercise is part of the treatment that increases the risk of tendons rising with scars and reduced movement.
Nerves slowly grow, so sensitivity returns for months and not always completely.
After surgery on the stand, we have special shoes and a few weeks' load limit.
After surgery on the wrist, the result depends largely on development. What is known about modern methods — and how well it has been proven.
The value of the operation depends on the volume, method, number of periods and days in the hospital; the surgeon calls it after examination.
You describe the request and, if you have it, you provide the results of the previous examination and treatment.
The doctor determines what situation we are in, what circumstances we need, what we need, and what his limitations are.
It discusses the next steps, the sequence of phases and the issues of reconstruction.
Patients come from all over Ukraine and abroad.
What happened and when?
What's wrong with grabbing, feeling, standing on your feet?
What kind of surgeries have you had?
Is there an X-ray, a C.T., a discharge?
What's your job and your main hand?
What medications do you take, do you smoke?
The short answers are that what suits you is what the doctor will tell you.
The thumb is restored by transplanting the toe to the wrist; other options are coccyx extension or transfer of an adjacent finger. Method is chosen after examination.
Usually not enough, especially when a second finger is taken; patients may have complaints about walking foot.
The nerve grows slowly, so sensitivity returns gradually, for months, and not always completely.
Usually a few weeks, and exercises with the rehabilitologist begin earlier, according to the surgeon's scheme. The exact dates depend on which tendon is sutured.
Often this is the case: minimally invasive surgery is done through a few millimetres of incision. Whether it's right for you, is decided by X-ray and degree of deformation.
Stop the bleeding and call 911. Wrap your finger in gauze moistened with salt water or clean water, place it in a closed bag and put the bag into a container of ice and water. Your finger should not touch either ice or water!
Review and meta-analysis of methods on the page.
Start consulting to see what questions and materials are needed for the evaluation.