PIP reconstruction with vascularized PIP joint from the second toe: minimizing the morbidity with the "dorsal...

Toe joint transplantation is a valuable procedure for reconstruction of the PIP joint of the finger. The authors describe recent refinements in the surgical procedure that have permitted them to reduce the morbidity on the donor site and simplify the whole procedure. A single dorsal approach is used at a digital level, allowing exposure of the recipient vessels (palmar collateral artery and superficial dorsal vein) and resection of the joint remnants. The PIP transfer is harvested through a limited dorsal incision, and reconstruction of the donor toe is achieved using a bone graft and a cross-toe flap. An average range of motion of 43 degrees has been achieved in this series with a mean follow-up of 42 months.