Special field

Hand and foot

Hand surgery is the special field for which knowledge and technique of plastic surgery and orthopedics are needed. Our hospital is a hand surgery authorization special institution.

Congenital anomalies of hand

Thumb duplication

Each of the split thumbs has elements that need to be combined to recreate the best possible thumb.


Surgical reconstruction of the commissure must be free of skin graft.
Creation of a flap to recreate the commissure avoids interdigital contracture.

Cleft hand

Surgery is considered for variety of indications including transverse lying bones, a narrowed first web space, and the widening cleft.


Severe forms with an absent thumb and digits may benefit from free toe phalanx transfer or microsurgical toe transfer.

  • 母指多指症

  • 裂手症

  • 合指症

  • 横軸形成障害合短指症

Congenital anomalies of foot


The aim of surgery is cosmetic restoration of a normal appearance with structural integrity of the fifth toe. This can be accomplished by desyndactylization and resection of the accessory toe component.

Congenital constriction ring syndrome

Congenital constriction ring syndrome is characterized by circumferential constrictions around limbs or digits, acrosyndactyly of digits, terminal absence, and edema distal to constrictions.

The mainstays are excision of the ring and subcutaneous tissue combined with Z-plasty.


Lengthening of the shorted digital skeleton requires osteotomy of the sort element, bone grafting or distraction osteogenesis.


Macrodactyly is extremely difficult to treat.

Surgical options can be divided into procedures that limit ongoing growth or surgeries that reduce the size of the digits.

  • 多合趾症

  • 第Ⅳ趾短縮症

  • 絞扼輪症候群

  • 巨趾症

Hand and foot trauma

  • 切断指

  • 屈曲拘縮

Replantaion of amputated fingers

Surgery for fractures and dislocations, tendon and ligament ruptures, vascular and nerve injuries, skin defect


Dupuytren disease
Post-burn contracture
Post-traumatic contracture


  • Usami S, Okazaki M, Wakimura Y. Extensor Digiti Minimi Transfer for the Treatment of an Unstable Metacarpophalangeal Joint in Thumb Polydactyly Without Thenar Atrophy. Journal of Hand and Microsurgery 7: 110-111, 2015
  • Usami S, Kodaira S, Homma T, Okazaki M. Postoperative voluminal flap reduction after fingertip reconstruction using the reverse digital artery island flap. Hand Surgery 20: 133-136, 2015
  • 宇佐美聡, 森 弘樹, 末貞伸子, 岡崎 睦, 小平 聡. Total balanceを考慮した指尖部再建̶整容面と皮弁採取部への慮̶. 日本マイクロサージャリー学会会誌 28: 152-158, 2015
  • Okazaki M, Hasegawa H, Kano M, Kurashina R. A different method of fingertip reconstruction with the thenar flap. Plast Reconstr Surg 2005; 115: 885-888.
  • Okazaki M, Yoshimura K, Fujiwara H, Suzuki Y, Harii K. Induction of hard keratin in non-nail-matrical keratinocytes by nail-matrical fibroblasts through epithelial-mesenchymal interaction. Plast Reconstr Surg 2003; 111: 286-290.