Stack versus Te Technique for Central Slip Reconstruction during Vascularized Toe Proximal Interphalangeal Joint...

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Vascularized toe proximal interphalangeal joint transfer can result in significant extension deficit.
• Central slip deficiency in donor toes is a primary cause of extensor lag.
• This study compares two techniques for central slip reconstruction: Stack and Te.

Purpose of the Study:

• To compare the long-term outcomes of vascularized joint transfers using the Stack versus the Te technique for central slip reconstruction.
• To evaluate the efficacy of each technique in correcting extension lag and improving joint function.

Main Methods:

• A retrospective review of 38 digits in 36 patients who underwent free vascularized toe joint transfer with central slip reconstruction.
• Eight digits were reconstructed using the Stack technique, and 30 digits used the Te technique.
• Follow-up data on extension lag, flexion, and range of motion were analyzed.

Main Results:

• The median follow-up was 19 months.
• No significant differences were found between the Stack and Te techniques in terms of extension lag (25 ± 29° vs. 20 ± 15°), flexion (75 ± 10° vs. 85 ± 20°), or range of motion (53 ± 23° vs. 63 ± 15°).
• Overall median extension lag was 20 ± 20° and flexion was 80 ± 20°.

Conclusions:

• Both Stack and Te techniques yield similar outcomes for correcting extension lag in vascularized joint transfers.
• The Te technique is a simplified and effective option for central slip reconstruction.
• Caution is recommended with the Stack technique due to potential complications.