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Toe-to-hand transfer in symbrachydactyly.
Philip W F Richardson1, Bruce R Johnstone, Christopher J Coombs
1Melbourne Paediatric Hand Centre, Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Australia.
Summary
Free toe transfer effectively treats symbrachydactyly, a limb deficiency. This surgical technique improves hand function and leads to high parental satisfaction, even with abnormal anatomy.
Area of Science:
- Congenital limb differences
- Pediatric reconstructive surgery
- Microsurgery
Background:
- Symbrachydactyly is a congenital limb deficiency characterized by abnormal hand or foot development.
- It is classified as a failure of formation, often presenting in adactylous or monodactylous forms.
- Conventional treatments have limitations, necessitating alternative reconstructive approaches.
Purpose of the Study:
- To evaluate the efficacy of free toe transfer in treating symbrachydactyly.
- To assess functional outcomes and parental satisfaction following the procedure.
- To demonstrate the technical feasibility of toe-to-hand transfer in patients with congenital anomalies.
Main Methods:
- A retrospective review of 18 free toe transfers performed in 13 patients with symbrachydactyly.
- Surgical technique involved transferring toes to reconstruct missing digits.
- Functional outcomes and patient/parental satisfaction were assessed post-operatively.
Main Results:
- All 18 free toe transfers were technically successful, despite abnormal underlying anatomy.
- The procedure resulted in significant improvements in hand function.
- High levels of parental satisfaction were reported post-treatment.
Conclusions:
- Free toe transfer is a viable and effective treatment option for symbrachydactyly.
- The procedure offers improved function and excellent patient outcomes.
- Microsurgical toe transplantation provides a solution for limb deficiencies when functional components are present.