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Single pedicle vascularized double joint transfer: anatomic study of two models
I C Chen1, T M Tsai, J C Firrell
1Christine M. Kleinert Institute for Hand and Micro Surgery, University of Louisville School of Medicine, KY, USA.
Microsurgery
|November 18, 1998
Summary
This study explored toe vascular anatomy for digital artery flaps. Two models for toe joint transfer were assessed, with Model I showing simpler procedures and lower risk for vascularity.
Area of Science:
- Orthopedic Surgery
- Vascular Anatomy
- Microsurgery
Background:
- Understanding vascular connections in the foot is crucial for reconstructive surgery.
- Toe joint transfers require detailed knowledge of blood supply to ensure flap viability.
Purpose of the Study:
- To investigate the communication between tibial and fibular digital arteries in the second toe.
- To evaluate two models for single pedicle vascularized double-joint transfer using toe segments.
- To assess the feasibility and safety of these models for hand reconstruction.
Main Methods:
- Microfil injection and angiographic studies to demonstrate vascular continuity.
- Dissection and mobilization of the neurovascular pedicle in two distinct models.
- Measurement of joint mobility distance (PIP to MTP joints).
Main Results:
- Anatomic pathways for retrograde blood flow to distal joint flaps were identified.
- Model I provided an average mobility of 5.6 cm, while Model II offered 5.1 cm.
- Model I involved less complex dissection and lower risk to flap vascularity compared to Model II.
Conclusions:
- Both models demonstrate potential for toe-to-hand joint reconstruction.
- Model I is preferable due to its simpler surgical approach and reduced risk.
- These vascularized toe joint transfers can potentially restore function in hand metacarpophalangeal (MCP) joints.