Medical Radiology and Radiation Safety. 2024. Vol. 69. № 6

DOI:10.33266/1024-6177-2024-69-6-33-37

A.V. Aksenenko, A.S. Samoilov, O.V. Parinov, A.Yu. Bushmanov, I.A. Galstyan,
A.A. Zavialov, G.E. Zimnikov, S.G. Kolyadin, Yu.G. Trofimenko, N.G. Stepanyanc,
G.A. Baksiyan, D.N. Astahov, M.Sh. Zugumova

Treatment and Rehabilitation of Professional Local Radiation Injury of the Hand, Using the Method of Transplanting the Toe to the Hand

A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

Abstract

Purpose: To introduce a wide range of specialists with the technique of reconstructive plastic surgery, which was first used in local radiation injury (LRI). 

Material and methods: clinical analysis of the case histories of  the severe LRI of the hand. The report describes the results of the first autotransplantation of the II toe in the position of the right hand III finger for the restoration of grip function in LRI. 

Results: Patient L., 38 years old, was admitted to the A.I. Burnazyan Federal Medical Biophysical Center in 2010 for the treatment of late consequences of severe LRI of the right hand resulting from contact with a gamma radiation source (Ir 192) in 2008. In the period from 2010 to 2018, the patient underwent repeated surgical operations, including reconstructive plastic surgery, which made it possible to achieve healing of constantly recurring late radiation ulcers. However, multiple necrectomies, exarticulations, finger amputations and resections of the phalanges led to the formation of a functionally defective hand and persistent disability of the patient. In 2018, the patient was admitted to the clinic for reconstructive surgery to restore the function of hand grip - microsurgical transplantation of the II toe into the position of the III finger of the hand. As a result of the treatment, the function of grabbing objects with the right hand was restored, and the patient’s ability to work was largely restored. 

Conclusions: The obtained long-term functional and aesthetic results allow us to consider the applied method of fingerless hand reconstruction by autotransplantation of the toe with the imposition of microvascular anastomoses optimal. It is advisable to use this type of surgical treatment more widely for the rehabilitation of patients with severe and extremely severe hand LRI.

Keywords: local radiation injury, hand, reconstructive plastic surgery, toe, autotransplantation

For citation: Aksenenko AV, Samoilov AS, Parinov OV, Bushmanov AYu, Galstyan IA, Zavialov AA, Zimnikov GE, Kolyadin SG, Trofimenko YuG, Stepanyanc NG, Baksiyan GA, Astahov DN, Zugumova MSh. Treatment and Rehabilitation of Professional Local Radiation Injury of the Hand, Using the Method of Transplanting the Toe to the Hand. Medical Radiology and Radiation Safety. 2024;69(6):33–37.
(In Russian). DOI:10.33266/1024-6177-2024-69-6-33-37

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Conflict of interest. The authors confirm that their authorship meets the international ICMJE criteria (all authors have made a significant contribution to the development of the concept, research and preparation of the article, read and approved the final version before publication).

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.07.2024. Accepted for publication: 25.09.2024.