title: Second-toe transfer for traumatic thumb amputation in children under 5 years: bone and soft-tissue growth.
abstract: BACKGROUND
  Posttraumatic thumb amputations in children under 5 years are uncommon. The final clinical long-term results have been reported shortly in literature. We report our clinical experience in children under 5 years with traumatic amputation of the thumb that were reconstructed using a second-toe transfer.
  
  
  METHODS
  There were 7 boys and 2 girls between the ages of 1 and 5 years. The follow-up was between 6 and 14 years. The average age at the time of transfer was 2.8 years, and the average follow-up was 10.7 years (range, between 6 and 14 y). The most frequent cause of amputation was avulsion (33.3%).
  
  
  RESULTS
  All the transferred toes survived and achieved bone union and static 2-point discrimination was averaged at 5 mm. They acquired good prehensile pinch and grasp. All of the structures of the transferred toes showed substantial growth.
  
  
  CONCLUSIONS
  Second-toe transfer for traumatic amputation of the thumb continues to be one of the best choices. Children require secondary procedures less often and in some cases late functional recovery can be expected. It is a safe procedure and there are fewer complications and a better success rate.
authors.affiliation: Plastic and Reconstructive Surgery Service, University of Antioquia, Medellín, Colombia.
authors.forename: German
authors.initials: G
authors.lastname: Wolff
authors.forename: Carolina
authors.initials: C
authors.lastname: Posso
mesh_terms: D000673:Amputation, Traumatic / Q000000981:diagnostic imaging / Q000601:surgery*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008297:Male; D008866:Microsurgery; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013933:Thumb / Q000000981:diagnostic imaging / Q000293:injuries*; D014034:Toes / Q000637:transplantation*