Is a Vascularized Interphalangeal Unicondylar Transfer Worth the Efforts? Surgical Technique and Clinical Application

Interphalangeal joints (IPJ) play a key role in hand function for performing activities of daily living and are frequently involved in complicated injuries resulting in significant functional limitations such as secondary arthritis and stiffness being the most challenging. In adult patients with more than 5 mm bone loss of the proximal articular surface who request a functional interphalangeal joint with minimal pain a vascularized joint transfer is a treatment choice. A unicondylar loss more than 5 mm wide in a 22-year-old carpenter is reported and illustrates our experience with a vascularized unicondylar transfer showing the advantages compared to the "classic" total joint transfer or distal interphalangeal (DIP) joint arthrodesis. By using this technique at the 12-month follow-up, we achieved no donor site complications, a good graft alignment, a good joint congruity, complete bone healing and a normal vascular patency with no signs of bone malunion or resorption of the graft.