Free Vascularized Second-Toe Distal Interphalangeal Joint Transfer for Reconstruction of Finger Defects

Abstract

Objective: Joint defects in the fingers due to osteoarthritis are often repaired with joint implants, arthrodesis or by vascularized proximal interphalangeal joint graft. The disadvantage of grafts, however, is that they may damage the donor toe. As a result of the discussion presented in this paper, we present evidence to indicate that vascularized distal interphalangeal joint transfers from the second toe may be able to be used in the reconstruction of these defects by using microsurgical techniques. Methods: In this study, we have operated on four cases of hand osteoarthritis using the technique. The distal interphalangeal joint of the second toe was transferred as a composite flap including tendons and/or digital artery perforator flap. There was a follow up period of three to fourteen months after the surgery. Results: All patients have gained an improved range of motion and stabilization of their joints. There was no skin necrosis or damage to the donor toes, and the function of the remaining proximal interphalangeal joint was preserved. Conclusion: There is evidence that a distal interphalangeal joint transfer can be a less invasive and effective technique for the reconstruction of traumatic proximal interphalangeal complex defects and advanced carpometacarpal arthritis of the thumb. International Microsurgery Journal. 2021;5(2):3 International Microsurgery Journal