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[Free transplantation of the 2d toe. Technical features, problems and solutions]
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|March 1, 1985
Summary
This study details techniques for toe transfers, emphasizing osteosynthesis plate use for stability. It also outlines optimal tendon and nerve repair strategies to prevent complications like PIP flexion contracture.
Area of Science:
- Microsurgery
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Toe transfers are complex reconstructive procedures.
- Optimizing surgical techniques is crucial for successful outcomes.
Purpose of the Study:
- To discuss technical features of toe transfers.
- To propose improvements for stability and functional recovery.
Main Methods:
- Review of eight toe transfer cases (seven single toe, one en bloc).
- Application of osteosynthesis plates for MP-arthrodesis.
- Specific tendon and nerve repair techniques discussed.
- Vascular reconstruction using dorsalis pedis or digitalis plantaris communis artery.
Main Results:
- Osteosynthesis plates provide stability, preventing secondary displacement and aiding accurate tendon tensioning.
- Suturing both extensor tendons and lumbrical muscle tendon helps avoid PIP flexion contracture.
- Successful revascularization achieved via dorsalis pedis or digitalis plantaris communis artery.
- Repair of all collateral plantar and dorsal nerves is essential.
Conclusions:
- Osteosynthesis plates enhance stability in toe transfers, especially with MP-arthrodesis.
- Specific flexor and extensor tendon repair strategies minimize contracture risks.
- Meticulous vascular and nerve repair, alongside appropriate soft tissue management, is key to successful toe transplantation.