Transferts osseux vasculaires libres (TOVL) « en bout de chaîne »

Abstract

The vascularized bone proved its capacity to be healed, without resorption even in sclerotic or infected tissue. Reconstruction of the distal part of the finger is often difficult for a pedicle transplant and a conventional bone transplant disappears. So the free vascularized bone transfer (FVBT) is indicated in distal post-traumatic finger amputations. According to the loss of substance to be reconstructed, the vascularised bone is harvested with some pulp, the nail complex or the cartilage of growth for a child. We report our experience of the technique of wrap around modified, of partial transfers of the second toe and the technique of reconstruction of claw nail deformity. The vascularised transfer of the cartilage of growth at the child is essential to allow the growth of the transferred phalanx. The indications are rare however the children, the musicians or the patients who require fine pinch can benefit from this type of sophisticated reconstructive microsurgery.