Modified metatarsophalangeal joint composite transplant from the second toe for reconstruction of composite dorsal tissue defects of the metacarpophalangeal joint caused by machinery injury

Abstract

Objective To explore a new modified procedure to transfer composite tissue of the metatarsophalangeal joint of the second toe to repair dorsal defects of the metacarpophalangeal joint and to evaluate its clinical efficacy.Methods From December 2006 to December 2011,according to the characteristics of metacarpophalangeal joint injuries by woodworking machinery in our district,a modified second toe metatarsophalangeal joint composite flap was designed.The dorsal parts of the composite tissue transplant were reserved.They were transferred to repair composite dorsal tissue defects in the coronal plane of the metacarpophalangeal joints of the hand.Results This group included defects of 23 metacarpophalangeal joints in 16 cases.Seventeen joints successfully reconstructed using the new modified technique were follow-up from 6 to 24 months.These joints showed X-ray evidence of bone healing in all cases.Recovery of joint function was satisfactory.According to the Functional Evaluation Criteria for Reconstruction of Thumb and Fingers issued by Hand Surgery Society of Chinese Medical Association,the excellent and good rate was 94.12 ％.Conclusion It is feasible to reconstruct composite dorsal tissue defects in metacarpophalangeal joints of the hand by transplantation of modified second toe metatarsophalangeal joint composite flap.Effective improvement of functions of the injured metacarpophalangeal joint can be achieved. Key words: Metacarpophalangeal joint; Metatarsophalangeal joint; Transplantation; Coronal plane; Dorsal