[Free toe transfer to the forearm stump following wrist amputation--a current alternative to the Krukenberg operation].
A new and simplified technique for reconstruction of the gripping ability after total loss of the hand is introduced. Previous techniques have not gained popularity because of the rather complicated procedures trying to extend the stump with two additional toes. Poor skin in the distal end of the stump has been a limiting factor and technically transplantation of two separate toes has been a difficult procedure. The stability in such a grip may be compromised. In the author's modification only one toe is used with an island flap from the big toe. The opposing post in this grip is the stable resection plane of the radius, covered partly by dorsal sensible skin and partly by the first web space skin with the island flap from the big toe. The stability is good because of the width of the post. The mobility of the new "thumb" may be excellent if the balance between the different muscle transfers is optimal and the rehabilitation is done in an adequate way from the beginning. This is a preliminary report of the technique and the preliminary results in three similarly operated patients are very promising. The technique is introduced especially as a modern alternative to the Krukenberg-plasty and may have its greatest value among blind patients with long forearm stumps.
D000328:Adult; D000673:Amputation, Traumatic / Q000150:complications / Q000601:surgery*; D001766:Blindness / Q000150:complications; D005542:Forearm / Q000601:surgery*; D006225:Hand / Q000502:physiology; D006230:Hand Injuries / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D009068:Movement; D013933:Thumb; D014034:Toes / Q000637:transplantation*
Freie Zehenübertragung auf den Unterarmstumpf nach Handgelenkamputation--eine moderne Alternative zur Krukenberg-Operation.