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The magazine of the American Society of Plastic Surgeons is the international benchmark in advances in plastic and reconstructive surgery.
The journal of the American Society of Plastic Surgeons (ASPS), Plastic and Reconstructive Surgery, collects in its September issue the latest works of Dr. Piñal in reconstructive strategies after thumb loss.
The article ‘Extreme Thumb Losses: Reconstructive Strategies‘ exposes new strategies for addressing complex amputations of the thumb in a single stage using existing muscles, immediate free tissue and toe to hand transplant.
During the article, the Spanish surgeon considers that the proximal amputations of the thumb go beyond the « simple » loss of a finger, grouping them under the denomination of extreme thumb reconstruction due to their complexity. In order to evaluate the immediate reconstruction of the thumb in a single stage, Piñal’s work analyzes the cases of 24 patients to validate this approach.
In his conclusions, Piñal states that in cases of thumb amputation the surgeon should pay attention not only to the loss of the thumb per se, but also to the thenar muscles, among other variables. In turn, recommends abandoning the standard practice of using pedicled groin flaps followed by toe to hand transferences, otherwise, he states, « the thenar muscles become useless, the first metacarpal contracts, and the need for tendon transfers skyrockets. ».
Dr. Piñal has performed around 500 finger transplants in the reconstruction of mutilated hands: the surgeon with a greater number of interventions of these characteristics on an international scale.
Born in Santander, northern Spain, in 1960, Dr. Francisco del Piñal is considered one of the world’s best upper limb surgeons. His contributions in the fields of microsurgical toe to hand transfer or arthroscopic surgery techniques on wrist fractures are endorsed and used internationally.