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Free vascularized small joint transfer to the hand
The Journal of Hand Surgery
|September 1, 1984
Summary
Free vascularized toe joint transfers successfully restore joint stability and function in children and adults. This procedure offers a viable option for digital joint reconstruction, preserving growth in pediatric patients.
Area of Science:
- Orthopedic surgery
- Microsurgery
- Pediatric orthopedics
Background:
- Free vascularized joint transfer aims to provide joint stability, painless range of motion (ROM), and growth potential in pediatric patients.
- This technique is considered for digital joint reconstruction when joint replacement is necessary due to local destruction.
Observation:
- Seven free vascularized digital joint transfers were performed (four children, three adults) between 1977 and the study period.
- Donor sites included the second toe's metatarsophalangeal and proximal interphalangeal (PIP) joints, and a small finger's PIP joint.
- Recipient sites were digital PIP and metacarpophalangeal (MP) joints, and a thumb's MP joint.
Findings:
- Six of seven procedures were successful, achieving stable, painless functional ROM with normal joint space.
- Children demonstrated continued normal growth from open epiphyseal centers.
- Follow-up averaged 3.5 years, with asymptomatic feet and some observed extensor tendon adherence.
Implications:
- Free toe joint transfer is a successful reconstructive option for digital joint loss in children and young adults.
- The procedure preserves joint function and growth potential, offering an alternative to joint replacement.
- Consideration of free toe joint transfer is recommended for digital joint reconstruction in pediatric and young adult populations.