Abstract

PLACER, A.  and  LOZANO, J.A.. Microsurgical 2^nd toe transfer for catastrophic hand reconstruction. Anales Sis San Navarra [online]. 2007, vol.30, n.3, pp.481-486. ISSN 1137-6627.

The correct reconstruction of the catastrophic hand requires complex surgical techniques. The microsurgical transference of a toe is indicated when all other reconstructive options are shown to be useless for the reconstruction of the required clamp function. In this clinical note we set out the case of a 32 year old man, who came to our accident and emergency department after suffering a traffic accident. After exploration the diagnosis was that of catastrophic left hand, among other policontusions. Urgent surgery was carried out, saving the maximum possible viable structures. The immediate result of this surgery was a hand with 1^st, 4^th and 5^th functional fingers. As the essential clamp function between the 1^st and 4^th or 5^th fingers was not totally satisfactory, we decided to reconstruct the 3^rd finger of his hand with his ipsilateral 2^nd toe. All pertinent studies to determine vascularisation of the flap were carried out in planning the surgery, and the microsurgical transfer was then realized, which was successful. Today, after a suitable rehabilitation, the patient has recovered a satisfactory function of heavy and fine clamp in the operated hand. Toe to hand transfer is a good option for finger reconstruction and its function. Rehabilitation is the key to functional recovery.

Keywords : Toe to hand transfer; Finger reconstruction; Microsurgery.

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