Etude rétrospective de 17 transferts d'orteils. Corrélation entre techniques chirurgicales et résultats fonctionnels

Abstract

The functional results of 17 toe transfers (15 second toes, 1 great toe and 1 monobloc second and third toes) are presented: arteries: 16 revascularisations achieved successfully out of 17. Veins: only one re-exploration had to be performed and it was successful. Osteosynthesis: performed in 10 cases with plate and screws, in 5 cases with a single K-wire and in 1 case with a double K-wire. No osteosynthesis was necessary in one case. Uneventful bone healing was always achieved. Tendons: the amplitude of movement at the interphalangeal joints (PIP & DIP) in post-traumatic cases is sufficient to ensure the desired function. In cases of congenital anomaly, however, the mobility of the transferred toe is almost nonexistent and function relies on the mobility of the recipient stump. Nerves: either discriminative or protective sensation was always obtained. Skin: in all cases adequate skin cover was obtained without resorting to a flap. Sequellae at the foot: there are virtually none when the second toe is removed. Various gait impediments occur, however, particularly on uneven surfaces, when the great toe or the monobloc second and third toes are removed.