| The wrap around toe technique for thumb reconstruction was devised by Mr. Wayne Morrison at the Microsurgery Research Centre in Melbourne, Australia. It is useful to reconstruct an aesthetically pleasing, sensate and functional thumb when amputation is distal to the metacarpophalangeal joint. Unlike other toe transfers, it preserves most of the length of the donor toe and narrows the reconstruction to a width normal for a thumb. These images are my pictures of the work of Mr. Morrison. |
| Click on each image for a larger picture |
| Preoperative appearance following avulsion and skin graft a partial thumb amputation: The skin graft skin cover is inadequate: tight, no padding, not durable, insensate. |
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| The envelope of the toe is harvested with only the portion of the distal phalanx required to support the nail bed. A medial strip of skin is left on the toe to cover the donor tip. |
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| Initial intraoperative positioning. |
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| Two weeks after surgery: |
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| Toe donor site - intermediate phase: the plantar surface is covered with a dorsal cross toe flap from the second toe. |
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| The toe tip is covered with the medial skin flap and a skin graft covers the dorsum. The syndactyly will is released at a second stage. |
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| Late Xray, showing the intercalated iliac crest graft between the recipient proximal phalanx and the donor distal phalanx. The inclusion of the tip of the distal phalanx prevents late distal resorption, which occurs when the distal phalanx is not included. |
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