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[Partial toe transfers. Functional results: apropos of 26 cases]
J Girot1, F Marin-Braun, F Dap
1Service de Chirurgie Plastique et Reconstructive de l'Appareil Locomoteur, C.H.U. Nancy, Hôpital Jeanne-d'Arc, Toul.
Summary
Partial toe transfers effectively reconstruct thumbs and fingers after trauma, with good recovery of function. Pulp transfers offer better sensitivity than composite transfers, though donor foot issues like cold intolerance can occur.
Area of Science:
- Microsurgery
- Orthopedic Surgery
- Reconstructive Surgery
Context:
- Post-traumatic defects of the hand often require complex reconstructive solutions.
- Toe-to-hand transfers are a valuable option for digital and thumb reconstruction.
- Partial toe transfers offer a versatile approach to restoring function in distal hand amputations.
Purpose:
- To evaluate the outcomes of partial toe transfers in post-traumatic thumb and finger reconstruction.
- To compare the results of pulp versus composite tissue toe transfers.
- To assess functional recovery, donor site morbidity, and patient satisfaction.
Summary:
- Twenty-six partial toe transfers (11 pulp, 15 composite) were performed for thumb (22) and finger (4) reconstruction.
- One arterial thrombosis resulted in failure.
- Satisfactory sensitivity (Weber 9 mm) was achieved with pulp transfers; composite transfers were less satisfactory.
- Good recovery of mobility and strength was generally observed.
- Donor foot issues included slow healing and cold intolerance in one-third of patients, with rare functional deficits.
Impact:
- Partial toe transfers, particularly pulp transfers, provide a viable option for thumb reconstruction, preserving the metacarpophalangeal joint.
- The study highlights the trade-offs between different partial toe transfer techniques regarding functional outcomes and donor site morbidity.
- Findings inform surgical decision-making for complex hand defects, emphasizing patient selection and technique choice.