[Experimental and clinical studies on free toe-joint transplantation to replace a finger joint by microvascular...

Major vascular pattern of the toe joints was investigated with template and transparent specimens in ten lower limbs of five Japanese monkeys and seven adult human amputated lower limbs. This led to the conclusion that the metatarsal artery should be used for toe MP joint grafts, while the unilateral proper digital artery is suitable for toe PIP joint grafts, together with concomitant or dorsal cutaneous vein. Twelve PIP and nine MP joints, a total of twenty-one experimentally grafted monkey toe joints with the above described vascular pedicles were radiologically and functionally in excellent condition after twelve months, whereas twenty-seven experimentally grafted monkey toe joints without vascular pedicles fell into cartilage degeneration after six months. Based on the results obtained from these experimental studies, nine human finger joints, consisting of two CM, four MP and three PIP joints, were replaced with either toe MP or PIP joints. One and half years on average after the grafting, the grafted toe joints were radiologically and functionally normal with growth of the open epiphysis.