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[Toe transfer to a mid-hand stump covered with abdominal skin]
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|January 1, 1986
Summary
Toe transfers can restore function to hands after finger amputation. Careful surgical technique, including adequate tissue length and flap routing, is crucial for successful toe-to-hand reconstruction and avoiding complications like infection and thrombosis.
Area of Science:
- Reconstructive surgery
- Microsurgery
- Hand surgery
Context:
- Amputation of all four fingers results in a functionally compromised hand.
- Abdominal flaps are used for coverage but offer limited functional restoration.
- Toe-to-hand transfer is a reconstructive option for severe hand injuries.
Purpose:
- To report experiences with toe transfers in patients with complete finger amputations.
- To evaluate the functional outcomes and identify critical surgical factors for success.
- To compare outcomes based on adherence to specific surgical principles.
Summary:
- Three toe transfers were performed on two patients (22-year-old male, 50-year-old female) with four-finger amputations.
- Successful transfers required harvesting vessels, nerves, and tendons to the extensor retinaculum (12-15 cm length).
- Meticulous flap routing prevented ischemia and infection; one transfer failed due to arterial thrombosis and infection secondary to suboptimal technique.
Impact:
- Successful toe transfers can significantly improve hand function after devastating injuries.
- Adherence to precise surgical techniques, including adequate tissue length and careful flap management, is paramount for successful outcomes.
- This study highlights the potential of toe-to-hand transfer as a viable reconstructive option when performed with meticulous attention to surgical detail.