Digital Transfer for Hand Reconstruction in Cleft Hand and Foot Differences

Area of Science:

• Pediatric Orthopedics
• Hand Surgery
• Congenital Hand Differences

Background:

• Cleft hand and foot differences present unique reconstructive challenges in pediatric patients.
• Anomalous anatomy requires specialized approaches for functional improvement.

Purpose of the Study:

• To evaluate the outcomes of digital transfer in children with cleft hand and foot differences.
• To assess the functional benefits and technical challenges of this reconstructive procedure.

Main Methods:

• Retrospective review of medical records for patients treated between 1996 and 2018.
• Analysis of patient characteristics, surgical indications, anatomy, and complications from available records and imaging.
• Inclusion of 20 digital transfers in 16 pediatric patients.

Main Results:

• All 20 digital transfers in 16 patients survived, with a mean age of 6 years at transfer.
• Recipient sites primarily included the thumb (17) and index ray (3).
• Various donor sites were utilized, including toes and polydactylous digits; revisions were performed for complications like nonunion and instability.

Conclusions:

• Digital transfer is a viable functional procedure for improving sensation, mobility, and opposition in pediatric cleft hands.
• Despite technical challenges due to small structures and atypical anatomy, these transfers offer significant functional and aesthetic improvements.
• This therapeutic study, reflecting level IV evidence, highlights the value of digital transfer in rare pediatric hand anomalies.