Related Experiment Video
Updated: Jun 6, 2026
10:36
Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025
[Pedicled joint transfers in the fingers]
1SOS main Strasbourg centre, centre de la main, établissement des diaconesses, 2-4 rue Saint-Elisabeth, Strasbourg, France. marinbraun@aol.com
Chirurgie De La Main
|November 20, 2010
Summary
Composite island homodigital grafts effectively reconstruct proximal interphalangeal joint losses, improving pain and mobility in manual laborers. This surgical technique offers a viable solution for digital joint reconstruction.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Microsurgery
Context:
- Proximal interphalangeal joint (PIPJ) reconstruction is challenging due to its critical role in finger function.
- Significant articular loss in the PIPJ often necessitates complex reconstructive procedures.
- Existing techniques for PIPJ reconstruction have limitations.
Purpose:
- To evaluate the efficacy of composite island homodigital grafts for PIPJ reconstruction.
- To compare the outcomes of this technique with other available procedures.
- To determine the optimal indications for pedicled articular transfers in PIPJ restoration.
Summary:
- A retrospective series of 27 patients with destroyed PIPJs underwent composite island homodigital graft reconstruction.
- Patients were predominantly young male manual workers with affected third and fourth fingers.
- The procedure preserved the distal interphalangeal joint, flexor tendon, and vascular pedicles.
Impact:
- No vascular complications were reported, with significant improvements in pain scores (7 to 2) and grip strength (54% of contralateral side).
- Average flexion-extension arc was 43°, with a mean 7-month return to work.
- While technically demanding, this method provides superior mobility compared to alternatives, making it valuable for specific indications, especially in emergencies.
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