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A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction

Free vascularized joint transfers (VJT) are indicated for reconstruction of a composite defect of the finger joints. When the bone defect involves the proximal interphalangeal joint (PIPJ) and the full length of the middle phalanx, using the toe PIPJ with a shorter middle phalanx to reconstruct such...

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Autores principales: Lin, Yu-Te, Loh, Charles Yuen Yung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7858630/
https://www.ncbi.nlm.nih.gov/pubmed/33552808
http://dx.doi.org/10.1097/GOX.0000000000003338
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author Lin, Yu-Te
Loh, Charles Yuen Yung
author_facet Lin, Yu-Te
Loh, Charles Yuen Yung
author_sort Lin, Yu-Te
collection PubMed
description Free vascularized joint transfers (VJT) are indicated for reconstruction of a composite defect of the finger joints. When the bone defect involves the proximal interphalangeal joint (PIPJ) and the full length of the middle phalanx, using the toe PIPJ with a shorter middle phalanx to reconstruct such a defect will be difficult. In this article, we describe an unusual application to repair the composite defect with a reversed inset of the toe PIPJ, where the proximal phalanx of the toe is placed distally and vice versa. METHODS: We describe a new technique to repair the composite defect with a reversed inset of the toe PIPJ. A 33-year-old woman sustained a crush injury to the left, middle, and ring finger, having fallen off her moped in a road traffic incident. A vascularized PIPJ from the second toe along with a hemipulp (1 × 4 cm) from the great toe transfer was performed with a reverse inset. RESULTS: With intensive physiotherapy and surgical tenolysis, a range of motion of 20–80 degrees at the new PIPJ was achievable. The joint motion was stable, and the radiograms of the finger demonstrated no visible joint degeneration. She reported the use of the finger, which improved overall hand function. CONCLUSION: Reverse inset of toe PIPJs is possible in simultaneous reconstruction of damaged finger PIPJs and building up of bony length distally.
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spelling pubmed-78586302021-02-05 A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction Lin, Yu-Te Loh, Charles Yuen Yung Plast Reconstr Surg Glob Open Hand/Peripheral Nerve Free vascularized joint transfers (VJT) are indicated for reconstruction of a composite defect of the finger joints. When the bone defect involves the proximal interphalangeal joint (PIPJ) and the full length of the middle phalanx, using the toe PIPJ with a shorter middle phalanx to reconstruct such a defect will be difficult. In this article, we describe an unusual application to repair the composite defect with a reversed inset of the toe PIPJ, where the proximal phalanx of the toe is placed distally and vice versa. METHODS: We describe a new technique to repair the composite defect with a reversed inset of the toe PIPJ. A 33-year-old woman sustained a crush injury to the left, middle, and ring finger, having fallen off her moped in a road traffic incident. A vascularized PIPJ from the second toe along with a hemipulp (1 × 4 cm) from the great toe transfer was performed with a reverse inset. RESULTS: With intensive physiotherapy and surgical tenolysis, a range of motion of 20–80 degrees at the new PIPJ was achievable. The joint motion was stable, and the radiograms of the finger demonstrated no visible joint degeneration. She reported the use of the finger, which improved overall hand function. CONCLUSION: Reverse inset of toe PIPJs is possible in simultaneous reconstruction of damaged finger PIPJs and building up of bony length distally. Lippincott Williams & Wilkins 2021-01-26 /pmc/articles/PMC7858630/ /pubmed/33552808 http://dx.doi.org/10.1097/GOX.0000000000003338 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Hand/Peripheral Nerve
Lin, Yu-Te
Loh, Charles Yuen Yung
A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction
title A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction
title_full A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction
title_fullStr A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction
title_full_unstemmed A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction
title_short A Reversed Inset Toe PIPJ Vascularized Joint Transfer for Finger PIPJ Composite Defect Reconstruction
title_sort reversed inset toe pipj vascularized joint transfer for finger pipj composite defect reconstruction
topic Hand/Peripheral Nerve
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7858630/
https://www.ncbi.nlm.nih.gov/pubmed/33552808
http://dx.doi.org/10.1097/GOX.0000000000003338
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