. Annals of surgery . ;,n()up belong Huguiers operation (1852)(phalangization or clefting) in which a new thumb is made from the firstmetacarpus, b. Finger substitution, c. Rotation of the remaining fingers. In the complete loss of the thumb. Lauenstein ( 1880) did an osteotomy ofthe second and fifth metacarpals and rotated the index and little fingers so thattheir palmar surfaces faced each other. In this manner the hand was hollowedand a certain amount of grasp obtained, d. A combination of the above three methods, as performedby Perthes phalangiza-tion, finger transplanta-tion and rotation.
. Annals of surgery . ;,n()up belong Huguiers operation (1852)(phalangization or clefting) in which a new thumb is made from the firstmetacarpus, b. Finger substitution, c. Rotation of the remaining fingers. In the complete loss of the thumb. Lauenstein ( 1880) did an osteotomy ofthe second and fifth metacarpals and rotated the index and little fingers so thattheir palmar surfaces faced each other. In this manner the hand was hollowedand a certain amount of grasp obtained, d. A combination of the above three methods, as performedby Perthes phalangiza-tion, finger transplanta-tion and rotation. Treatment of Muti-lations of the ThumbWhere the first Meta-carpus or a SubstantialPortion of it RemainsIntact.—Such cases areto be treated byHuguiers operation(phalangization) or byNicoladonis secondmethod. A short butuseful thumi) is ob-tained by Huguiersoperation. This newthumb is made from themetacarpus. Huguiertaking advantage of thewell-known mobility ofthe first metacarpus,its inferiorby enlarginginterosseous. Fig. 9.^.—Result of Huguiers operation. Formation of a newthumb from stump of first metacarpus. Boy aged nine. Thumb,index, middle and ring fingers blown away by an exploding shell fuseJuly 20, 1916, Monlmacq Oise. France. He sustained a seriouscompound comminuted fracture of remaining metacarpals, withextensive laceration of soft parts. Treated by Carrel method. Opera-tion July 30, 1916. renderedhalf freethe firstspace. Technic.—The inci-sions will vary with theWith the hand prone scar-tissue and with the amount of availalile a dorsal incision midway between first and second metacarpals, theupper corresponding to the middle of the high portion of theinterosseous space. This dorsal incision the external border and baseof the first interosseous and the dorsal aspect of the metacarpals. Divide theinterosseous where it is attached to the bone and reimplant. If present, tendon of the adductor of the thumb, detach it from i
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
