title: Proximalization of the Vascularized Toe Joint in Finger Proximal Interphalangeal Joint Reconstruction: A Technique to Derive Optimal Flexion From a Joint With Expected Limited Motion.
abstract: When used to reconstruct a finger proximal interphalangeal joint, a free toe interphalangeal joint, without modification, cannot meet the motion demands of the finger to allow palm touchdown. This limitation is the direct result of the toe interphalangeal joint having an intrinsic arc of motion that delivers less flexion than that of a normal functioning finger proximal interphalangeal joint. By modifying the inset of the transferred joint to an extra-anatomical more proximal position, this limitation can be overcome. With a mathematical justification highlighted by a clinical illustration, we demonstrate the feasibility and utility of this "proximalization" technique.
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
authors.forename: Raja
authors.initials: R
authors.lastname: Mohan
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
authors.forename: Victor W
authors.initials: VW
authors.lastname: Wong
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD.
authors.forename: James P
authors.initials: JP
authors.lastname: Higgins
authors.affiliation: Curtis National Hand Center, MedStar Union Memorial Hospital, Baltimore, MD. Electronic address: anne.mattson@medstar.net.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Katz
mesh_terms: D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D014033:Toe Joint / Q000098:blood supply*; D014034:Toes / Q000637:transplantation*
keywords: Free toe joint; proximal interphalangeal joint; proximalization; reconstruction