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Second toe transfer for thumb reconstruction in multiple digit amputations including thumb and basal joint.
T M Tsai1, S McCabe, M E Beatty
1Department of Orthopedic Surgery, University of Louisville School of Medicine, KY 40202.
Microsurgery
|January 1, 1987
Summary
Second toe transfers offer a viable solution for thumb reconstruction after amputation at the basal joint. This reconstructive surgery restores functional pinch and grip strength with high patient satisfaction.
Area of Science:
- Reconstructive surgery
- Microsurgery
- Orthopedic surgery
Background:
- Thumb amputation, particularly involving the basal joint, presents significant functional disability.
- Limited reconstructive options exist for such severe thumb injuries.
Observation:
- Three cases of multiple digit amputation including the thumb and basal joint were treated.
- A second toe transfer was utilized for thumb reconstruction in all cases.
Findings:
- Patients achieved functional pinch, with average pinch strength at 27% of the uninjured extremity.
- Average grip strength was 44% of the contralateral hand.
- The transferred toe demonstrated average motion of 25° (MP), 37° (PIP), and 9° (DIP), with obtainable adduction/abduction.
Implications:
- Second toe transfer is a promising option for reconstructing proximally amputated thumbs.
- This technique provides functional restoration without donor site morbidity.
- Patient satisfaction was high, indicating the procedure's efficacy in selected cases.