Technical keys in maximizing finger proximal interphalangeal joint motion after vascularized toe joint transfers

被引:10
作者
Lin, Yu-Te [1 ,2 ]
机构
[1] Chang Gung Mem Hosp, Vascularized Composite Allotransplantat Ctr, Dept Plast Surg, Keelung, Taiwan
[2] Chang Gung Univ, Coll Med, Taoyuan, Taiwan
关键词
Vascularized joint transfer; extensor tendon repair; range of motion; extension deficit; central slip; lateral band; RECONSTRUCTION; ANATOMY; TRANSPLANTATION; RANGE; HAND;
D O I
10.1177/1753193419857475
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Vascularized toe joint transfers to the fingers have been performed for more than four decades, but their outcomes are not comparable with implant arthroplasty. Limited range of motion and extensor deficits of about 30 degrees remain major problems with the constructed joints. We observed that the central extensor tendon of the toe is often attenuated proximally in its course on the dorsum of the proximal interphalangeal joint. A tight repair of the toe extensors to finger extensors limits joint motion. We reviewed our surgical techniques with this consideration. Thirty-eight fingers that we followed for 6 to 123 months had active range of motion of the reconstructed proximal interphalangeal joint in the finger of 58 degrees (range 17 degrees-76 degrees) with an extensor deficit of 18 degrees (range 0 degrees-30 degrees). We consider that the extensor mechanism and central slip insertion to the middle phalanx must be reconstructed meticulously to improve joint motion and decrease extension lag, and design of a lateral skin flap paddle to better cover vessels and allow extensor repairs.
引用
收藏
页码:667 / 675
页数:9
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