: The aim of this study is to present various hand reconstruction methods and provide technical notes regarding the treatment of mutilating hand injuries using free-tissue transfers from the foot and to investigate whether these transfers provide patients with a usable hand or not.
TOE THUMBS FREE
The functional and aesthetic results of both the donor and the recipient sites were satisfactory.ĬONCLUSIONS Compared to the great toe or second toe transfer, combined free transfer of the great toenail flap and 2nd toe phalange achieved a substantially better functional and aesthetic result in the thumb reconstruction. RESULTS 1 patient suffered from a partial flap necrosis and received a groin flap to cover the defect. Each of the patients’ thumbs had different levels of amputation at the metatarsophalangeal joint (MPJ) or distal interphalangeal joint (DIPJ). Divided evenly into three groups of ten, group one received a great toe transplantation, group two received a second toe transplantation, and group three received a combined great toenail flap and second toe phalange transplantation. From October 2009 to July 2019, 30 patients with traumatic thumb defects received one of 3 different kinds of thumb reconstruction in our clinic according to their level of amputation.
METHODS We experimented with three different methods of toe to hand transfer. Results show that, for patients with traumatic thumb defects, the combined transfer of flap and second toe phalanx was the best option.Ĭompared to the great toe or second toe transfer, combined free transfer of the great toenail flap and second toe phalanx achieved a substantially better functional and esthetic result in the thumb reconstruction. The functional and esthetic results of both the donor and the recipient sites were satisfactory. One patient suffered from a partial flap necrosis and received a groin flap to cover the defect. Each of the patients' thumbs had different levels of amputation at the metatarsophalangeal joint (MPJ) or distal interphalangeal joint (DIPJ). Divided evenly into three groups of ten, group one received a great toe transplantation, group two received a second toe transplantation, and group three received a combined great toenail flap and second toe phalanx transplantation. We experimented with three different methods of toe to hand transfer. It is difficult to maintain both functional and esthetic satisfaction in thumb reconstruction. Great toe transplantation achieves better esthetics, but hindered walking, due to the foot's loss of the great toe and moreover suboptimal thumb function. Second toe transplantation achieves good function, but poor esthetics. Great toenail flap, thumbnail valva flap, free great toe, and second toe transplantation are the common methods in thumb reconstruction. Microsurgical toe-to-hand transfer is a gold standard when it comes to repairing a thumb defect. Results show that, for patients with traumatic thumb defects, the combined transfer of flap and 2nd toe phalanx was the best option.ĬONCLUSIONS Compared to the great toe or second toe transfer, combined free transfer of the great toenail flap and 2nd toe phalanx achieved a substantially better functional and aesthetic result in the thumb reconstruction. The functional and aesthetic results of both the donor and the recipient sites were satisfactory. It is difficult to maintain both functional and aesthetic satisfaction in thumb reconstruction. Great toe transplantation achieves better aesthetics, but hindered walking, due to the foot’s loss of the great toe and moreover suboptimal thumb function.
Second toe transplantation achieves good function, but poor aesthetics. Great toenail flap, thumbnail valva flap, free great toe and second toe transplantation are the common methods in thumb reconstruction. BACKGROUND Microsurgical toe-to-hand transfer is a gold standard when it comes to repairing a thumb defect.