Free PIP Joint Transfer for Functional Finger Reconstruction
- 2 Downloads
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.
KeywordsJoint transfer Vascularized joint Toe to hand Free joint transfer Toe flap
- Gilbert A. Composite tissue transfers from the foot: anatomic basis and surgical technique. In: Daniller A, Strauch B, editors. Symposium on microsurgery. St Louis: Mosby; 1976.Google Scholar
- Lin CH, Sassu P. Toe flaps and toe transplantation. In: Wei FC, Mardini S, editors. Flaps and reconstructive surgery. 1st ed. Philadelphia: Saunders; 2009. p. 473e500.Google Scholar