Repair of proximal interphalangeal joint (finger) defects using the second toe proximal interphalangeal joint with skin flaps

Abstract

Objective To discuss the clinical efficaey of repairing proximal interphalangeal (PIP) joint (finger) defects by transferring the second toe PIP joint with mlni-flaps. Methods PIP joint transfer from the second toe with vascular anastomosis was used to repair 28 PIP joint (finger) defects in 23 cases, among which 18 were total joint transfer and 10 were semi-joint transfer. Results All 28 transphnts in 23 cases survived. Primary postoperative healing was achieved, without the occurrence of infection and osteomyelitis. All grafted joints clinically healed within 4 to 8 weeks. The bone healing time was 6 to 10 weeks. The duration of postoperative follow up was 5 to 16 months with an average of 9 months. Degeneration of grafted joints was absent. Palmar joint dislocation was found in one case with seml-joint transfer involving two and a half fingers, which was sueccssfully corrected by arthroplasty. The postoperative range of motion if the transferred PIP joint was 35° to 90°, with an average of 65°. According to joint movement TAM/TAF criteria, outcomes of this series were graded as excellent in 10 grafted fingers, satisfactory in 14 fingers, average in 2 fingers and poor in 2 fingers. Overall excellent and good rate was 86%. Conclusion Repair of PIP joint(finger) defects using PIP joint transfer from the second toe enables favorable functional recovery and joint movement that meets daily needs, providing satisfying functional improvement of the joints. Key words: Hand joints; Wounds and injuries; Tissue tramplantafion; Microsurgery