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A Novel Technique for Correcting Extensor Lag in Vascularized Toe PIP Joint Transfers
Yu-Te Lin1, Charles Yuen Yung Loh
1*Department of Plastic Surgery, Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital †College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Techniques in Hand & Upper Extremity Surgery
|June 10, 2016
Summary
Vascularized joint transfers using the second toe proximal interphalangeal joint (PIPJ) can restore hand function. A novel technique corrects extensor lag in reconstructed PIPJs, expanding patient eligibility for this procedure.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Microsurgery
Background:
- Vascularized joint transfers (VJTs) using the second toe proximal interphalangeal joint (PIPJ) are effective for restoring hand function.
- A common complication is extensor lag due to inadequate central slip formation in the toe's extensor mechanism.
- Existing correction methods are often complex and invasive.
Purpose of the Study:
- To introduce a novel, simple, and effective technique for correcting extensor lag in VJTs.
- To improve the outcomes of PIPJ reconstruction using toe joints.
- To broaden the applicability of VJTs by removing limitations related to toe joint anatomy.
Main Methods:
- A new surgical technique was developed to recreate the extensor tendon insertion point on the reconstructed finger.
- This method focuses on directly addressing the extensor lag issue inherent in toe-to-hand transfers.
- The technique aims for reproducibility and simplicity, minimizing dissection and soft tissue manipulation.
Main Results:
- The presented technique effectively corrects extensor lag in VJTs.
- This method simplifies the surgical process compared to traditional approaches like the Stack method.
- The technique allows for precise reconstruction of the extensor mechanism's insertion.
Conclusions:
- The novel technique provides a straightforward solution for extensor lag in VJTs.
- This innovation can eliminate the need to consider "toe PIPJ angles" as a strict selection criterion.
- More patients can potentially benefit from VJTs due to improved reconstructive options.
