Toe to thumb transfer for thumb defect reconstruction in children

Abstract

Objective To report the experience of toe transplantation in thumb and finger reconstruction in children.Methods From April 2005 to April 2011,13 cases of thumb or finger defects were treated with toe transplantation.Distal segment of the great toe was transferred in 2 patients with posttraumatic defects of distal part of the thumb.Second toe transplantation was performed in 5 patients with thumb defects.Bilateral second toe transfer was performed in 2 patients with posttraumatic defects of multiple fingers,1 patient with congenital transversal defect of the thumb,and 3 patients with congenital defects or dysplasia of fingers.Postoperative function of the reconstructed digits was evaluated.Results Postoperative follow-up period ranged from 16 months to 5 years.All the transplants in the 13 cases survived.Growth of the transplants was normal.The ability of grip was regained.Two-point discrimination was from 11 to 15 mm.According to the functional assessment criteria for thumb and finger reconstruction issued by the Hand Surgery Society of the Chinese Medical Association,the outcomes were excellent in 9 cases and good in 4 cases.There was no abnormal gait and pain in the donor foot.The function of the foot was not impaired.Conclusion The outcomes of toe transplantation in reconstruction of thumb and finger defects in children are satisfactory. Key words: Tissue transplantation; Child; Microsurgery; Reconstruction