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11-21-2012, 12:49 PM
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Severe Hand Avulsion Injury
A: Irreplantable fingers after an avulsion injury in a car accident. Massive contamination. Initial management included radical debridement. The small finger was totally destroyed and amputated. B: 72 hours later the extensor tendons were grafted, a second toe was transplanted on top of middle phalanx in the middle finger position, and a free gracilis was used for cover. A week later the contralateral second toe was transplanted on top of the middle phalanx of the ring finger, achieving a four digit hand. C: Early result (5 weeks) after the reconstruction. Click image for better size |