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Journal of Hand Surgery (British and European Volume)
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Articles

Modified "On-Top-Plasty" Technique for Restoring Length to Amputation Stumps

V. PISTRE
P. PELISSIER
A. BALLANGER
D. MARTIN
J. BAUDET

From the Department of Plastic Surgery, Hôpital du Tondu, Centre Hospitalier Universitaire Pellegrin, Bordeaux, France

Correspondence: Dr Vincent Pistre, Department of Plastic Surgery, University of Bordeaux 11 Hôpital Pellegrin Tondu, Place Amelie Raba-Leon, 33076 Bordeaux Cedex France.

Five patients were successfully treated with a modified "on-top-plasty" technique, in which a finger stump is lengthened by transfer of an adjacent amputation stump with a reverse blood flow fingerstump. This technique can be performed in the acute phase or as a secondary procedure. A conventional on-top-plasty can be performed by transfer of a partially amputated index or ring finger to the "top" of the proximal phalanx of an amputated middle finger. Alternatively, the transferred part may be used in an intercalated fashion to reconstruct the middle phalanx, using a prosthesis to reconstruct the proximal interphalangeal joint. The results, complications and disadvantages of the technique are reported. We propose this procedure for the reconstruction of the middle ring finger when a free microneurovascular toe-to-hand transfer is contraindicated or refused by the patient.

Journal of Hand Surgery (British and European Volume), Vol. 27, No. 3, 265-269 (2002)
DOI: 10.1054/jhsb.2001.0728
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