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Microvascular Toe Joint for Proximal Interphalangeal Joint Replacement: Indications, Technique, and Outcomes
Ryan D Katz1, James P Higgins1
1Care of Anne Mattson, The Curtis National Hand Center, MedStar Union Memorial Hospital, 3333 North Calvert Street, #200 JPB, Baltimore, MD 21218, USA.
Hand Clinics
|April 8, 2018
Summary
Free toe joint transfer offers a durable solution for proximal interphalangeal joint (PIPJ) reconstruction, despite technical challenges. This method provides lifelong stability and low infection risk, making it a valuable alternative to conventional arthroplasty.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Dysfunctional, absent, or destroyed proximal interphalangeal joints (PIPJ) present significant reconstructive challenges.
- Conventional arthroplasty may have limitations in durability and infection risk.
- Autogenous tissue transfer is an alternative reconstructive strategy.
Purpose of the Study:
- To evaluate the utility of microvascular toe interphalangeal joint transfer as an autogenous PIPJ arthroplasty.
- To compare the advantages and disadvantages of free toe joint transfer versus conventional arthroplasty.
Main Methods:
- Free microvascular toe joint transfer to reconstruct the proximal interphalangeal joint (PIPJ).
- Assessment of surgical technique, donor site morbidity, and patient outcomes.
- Comparison with established arthroplasty techniques.
Main Results:
- Microvascular toe joint transfer is technically demanding but offers significant benefits.
- Advantages include lifelong durability, coronal plane stability, and low infection rates.
- Growth potential exists for skeletally immature patients, a benefit over conventional implants.
Conclusions:
- Free toe joint transfer is a valuable, albeit complex, option for PIPJ reconstruction.
- Careful patient selection and risk-benefit assessment are crucial for optimal outcomes.
- This technique provides a durable, stable, and low-risk alternative in select cases.
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