Anatomical reconstruction of hand after tumor resection in auricular finger

18 mai, 2017

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The patient, an elderly woman, has a recurrent tumor in the little finger usually solved by a partial resection. Dr. Piñal opts in this case for a pioneering technique of anatomical reconstruction of the affected limb.

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The upper image shows the tumor mass that ‘deforms’ the fifth finger (little or auricular finger). In this case, the recurrent tumor is in its third appearance.

The problem

The main feature of the analyzed clinical picture is the existence of a recurrent tumor (ie recurrent comebacks after subsequent eliminations) on the fifth finger of the patient’s right hand.

The usual surgical approach in this type of situations is the partial amputation of the auricular finger (fifth finger or little finger). Thus, a stump remains whose presence supposes an aesthetic impact to be taken into account, especially from the psychological perspective of the patient.

The objectives

The pioneering technique of Dr. Piñal for the auricular finger in this type of clinical pictures has a double objective: on the one hand, and in line with the more conventional approach, to eliminate the tumor and the risk of recurrence; On the other, to restore the affected hand from an aesthetic-anatomical point of view, which facilitates the acceptance of the new nature of the limb by the patient, also guaranteeing full functionality.

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The illustration above, in its left segment, shows the aesthetic-anatomical result of a conventional approach. Next, one can observe the detail of bone displacement and fusion techniques, as well as the final result of these actions and of the nerve transposition performed in the new surgical design developed by Dr. Piñal for this type of case.

The plan

The surgical design of the Spanish surgeon starts from the resection of the auricular finger, to later conduct a displacement of the fourth finger to the forementioned finger original position. This displacement is accompanied by a bone combination of metacarpals of both fingers stabilized by screws.

In turn, Dr. Piñal performs a nerve transposition, that is, a transfer of the nerves of the affected area out of its natural anatomical position, so that they do not generate pain or discomfort.

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In this combination of images (left to right and top to bottom),the bone fusion by insertion of screws and the nerve transposition in the affected limb can be seen.

The results

As can be seen in the images of the case, the application of reconstructive surgery techniques allows the patient to have a hand with its aesthetic-anatomical and mobility functions restored, while -in turn- the tumor and the pain are eliminated.

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The minimization of the aesthetic impact and the scope of the reconstructive surgery in the anatomical restoration are evident in a daily situation context, already with the sutures removed.