Aesthetic shoulder reconstruction using hypoplastic tissue in a patient with phocomelia – A case report

Znanstveni rad - Prikaz slučaja

• Autor: Marc Miralles
• Autor: Patricia Videc
• Autor: Rado Žic
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA KIRURGIJU)
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti; Kirurgija

Sažetak (engleski)

We present a case describing a technique for the surgical management and aesthetico-functional reconstruction of a shoulder in an adult with unilateral upper limb phocomelia (ULP).1⁠ A 25 year old male patient was presented to our clinic with upper left limb non-syndromic phocomelia. His main concerns was an aesthetically unpleasant limb and shoulder shape. Few older publications describe available options for pediatric patients, such as clavicle transposition or limb amputation, but nowadays ULP treatment options focus on prosthetic rehabilitation (PR) and targeted muscle reinnervation (TMR). Our patient refused any prosthesis, and TMR is expensive, requires an experienced rehabilitation team and has limited availability. We aim to describe a non-expensive, simple and effective option for selected adult patients with limited shoulder functionality wishes.2-5 We used the existent hypoplastic limb for shoulder mound reconstruction, providing the patient with a more anatomical shoulder shape. The palmar skin of the hypoplastic hand and three existing fingers were excised. Also, distal phalanges were amputated. Then, the hand was rotated and positioned under the coracoid process, creating a shoulder-like mound. Six months later, there has been a loss of shoulder volume compared to early postoperative weeks, but the patient is satisfied with the results. Nevertheless, we found some limitations to our approach such as long-lasting postoperative pain, sensory symptomatology, and loss of volume of the reconstructed shoulder. Those could be solved with the complete denervation of the limb and a Latissimus Dorsi (LD) transposition flap in a second stage of reconstructive surgery.

• Ključne riječi (engleski): Case report; Phocomelia; Shoulder reconstruction; Surgical treatment
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Prikaz slučaja
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: JPRAS Open
• Brojčani podaci: vol. 37, str. 139-144
• p-ISSN: 2352-5878
• DOI: https://doi.org/10.1016/j.jpra.2023.06.006
• URN:NBN: urn:nbn:hr:105:283721
• Datum objave publikacije: 2023-07-01
• URL dokumenta: https://linkinghub.elsevier.com/retrieve/pii/S2352587823000256
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2024-09-02 08:36:15