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Updated: Jun 29, 2026

A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy

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[Second toe transfer in congenital hand differences].

G Dautel¹, S Barbary

¹Unité fonctionnelle de chirurgie de la main de l'enfant, service de chirurgie infantile orthopédique, hôpital de Brabois Enfants, CHU de Nancy, 5, allée du Morvan, 54500 Vandoeuvre-les-Nancy, France. gillesdautel@mac.com

Chirurgie De La Main

|October 14, 2008

Summary

This summary is machine-generated.

Microsurgical toe transfer successfully created functional digits in children with congenital hand differences, achieving excellent two-point discrimination and normal gait. Despite poor average active motion, toe transplants integrate well, showcasing cerebral plasticity.

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Area of Science:

Reconstructive Microsurgery
Pediatric Orthopedics
Congenital Hand Anomalies

Background:

Congenital hand differences often necessitate reconstructive procedures.
Microsurgical toe transfer aims to create functional digits where none exist.

Purpose of the Study:

To evaluate the functional outcomes of second toe transplantation in children with congenital hand differences.
To assess the integration, sensation, growth, and long-term functional impact of toe transfers.

Main Methods:

Performed 65 consecutive second toe transfers (with or without MTP joint) for symbrachydactyly, constriction band syndrome, or central cleft hand.
Focused on creating a 'tip-to-tip' pinch in adactylic or monodactylic hands.
Assessed total active motion (TAM), two-point discrimination, graft growth, and gait post-operatively.

Main Results:

Achieved excellent static two-point discrimination (<6mm) in 12/15 patients at 5-year follow-up.
Reported average TAM of 42° ± 24°, with two vascular failures and two mediocre integrations.
Observed toe graft growth of 68-95% and normal long-term gait in all children.

Conclusions:

Toe-to-hand transplantation is a viable option for congenital hand differences, yielding good sensation and functional gait.
The cerebral cortex demonstrates plasticity, facilitating transplant integration.
While active motion may be limited, functional pinch and sensation are significantly improved.