Free PIP Joint Transfer for Functional Finger Reconstruction

  • Paolo SassuEmail author
  • Martina Åhlén
Living reference work entry


Free vascularized joint transfer is indicated in young patients where other standard procedures such as joint fusion or arthroplasty are not ideal. Good functional results rely on meticulous surgical dissection and thorough understanding of the vascular anatomy of the donor foot. The PIP (proximal interphalangeal) joint of the finger is usually reconstructed with the toe PIP joint, while the MCP (metacarpophalangeal) joint of the hand can be reconstructed with either the toe PIP or MTP (metatarsophalangeal) joint. We describe a case of PIP joint reconstruction of the small finger in a young adult who performed rock climbing at a high level. The joint function was restored with a vascularized toe PIP joint from the third toe since the second toe, quite long in its anatomy, was spared in order to maintain excellent grip while wearing climbing shoe. Even though uncommonly used, the third toe PIP joint allowed full recovery in range of motion (ROM) with no donor site morbidity. The patient returned to his job within 3 months and climbing 8 months after surgery.


Joint transfer Vascularized joint Toe to hand Free joint transfer Toe flap 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Hand Surgery, Sahlgrenska University HospitalGothenburgSweden

Section editors and affiliations

  • Lucian Petru Jiga
    • 1
  1. 1.Dept Plastic & Reconstructive Surgery, Hand SurgeryEvangelishes Krankenhaus OldenburgBad ZwischenahnGermany

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