Premium
Free vascularized whole joint transfer in children
Author(s) -
Ishida Osamu,
Tsai TsuMin
Publication year - 1991
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.1920120309
Subject(s) - medicine , interphalangeal joint , phalanx , range of motion , epiphysis , joint (building) , metacarpophalangeal joint , deformity , surgery , transfer (computing) , anatomy , orthodontics , thumb , architectural engineering , parallel computing , computer science , engineering
Reconstruction of the traumatized finger joint with epiphyseal destruction has long been problematic. Since free vascularized whole joint transfer was introduced as a treatment for joint and epiphyseal destruction, this procedure has been selected as an alternative treatment because it may provide a growing epiphysis. We have reviewed our series of 19 joint transfers. Mean age at operation was 6.2 years (range 3 to 12). Average active range of motion was 31°/61° for the group with posttraumatic reconstruction (n = 12) and 21°/43° for the group with reconstruction of a congenital deformity (n = 7), with an overall average of 27°/54°. Average range of motion following transfer of an metatarsophalangeal (MTP) or metacarpophalangeal (MCP) joint to an MCP joint position was 39°/75° (n = 4); proximal interphalangeal (PIP) to PIP transfer was 22°/39° (n = 13); and PIP to MCP transfer was 38°/51° (n = 2). The proximal phalanges in MCP joints transferred to the MCP position grew an average of 7.0 mm, and the middle phalanges of joints transferred to the PIP position grew 4.3 mm. Almost normal growth was observed in all transferred joints except two that showed premature epiphyseal closure. Indications for this procedure and techniques to improve range of motion are described.