Vascularized toe-to-finger joint transplantation. 11 patients followed for 4 years.
Since 1983, we have transplanted 11 free vascularized joints in 8 men and 3 women, mean age 32 years. The causes of joint involvement were trauma in 9 cases and infection in 2. One MP and 10 PIP joints of the second toe were transplanted to 3 MP and 8 PIP joints of the fingers. After a mean postoperative follow-up period of 4 years, the mean postoperative range of motion was 31 degrees compared with 16 degrees preoperatively. Radiographs showed destruction of 4 PIP joints, probably caused by vascular failure in 2 joints and infection in 2. In spite of no evidence of arthrosis, some of the joints had gradually undergone a loss of extension. Although there are some problems that should be overcome, we advocate a free vascularized toe-joint transplantation for severe finger-joint destruction without extensive surrounding soft-tissue damage.
Imamura
K
K
Department of Orthopedics, Nagasaki University School of Medicine, Japan.
Nagatani
Y
Y
Hirano
E
E
D000293:Adolescent; D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000379:methods; D016059:Range of Motion, Articular; D014033:Toe Joint / Q000098:blood supply / Q000502:physiology / Q000601:surgery*