Free vascularized whole joint transfer in children

Area of Science:

• Orthopedic surgery
• Pediatric reconstructive surgery
• Microsurgery

Background:

• Reconstructing finger joints with epiphyseal destruction presents significant challenges.
• Free vascularized whole joint transfer has emerged as an alternative treatment.
• This technique offers the potential for a growing epiphysis in pediatric cases.

Observation:

• A series of 19 joint transfers were reviewed in children aged 3-12 years.
• Functional outcomes, including range of motion, were assessed for different transfer types.
• Bone growth in transferred epiphyses was measured to evaluate developmental potential.

Findings:

• The procedure demonstrated variable but often beneficial range of motion, particularly in post-traumatic reconstructions.
• Transferred joints, including metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints, showed significant bone growth.
• Most transferred joints exhibited near-normal growth, with only a few cases of premature epiphyseal closure.

Implications:

• Free vascularized whole joint transfer is a viable option for restoring function and growth in pediatric finger joint reconstruction.
• Understanding specific transfer types and surgical techniques can optimize functional outcomes.
• Further research into preventing premature epiphyseal closure could enhance long-term results.