Combined second toe and partial nail transfer from the big toe by means of an exteriorized pedicle.

Abstract

The hand of a three-year old girl was reconstructed by means of a bilateral second toe transplantation following traumatic amputation of all five digits. In a second operation, aimed at reconstructing the index finger, the nail apparatus of the big toe was transferred to the thumb as an "island flap" based on a pedicle from the second toe. The thumb was subsequently lengthened enabling a three-fingered hand to be obtained with only minimal functional impairment of the feet. The authors suggest an original technique allowing transfer of the second toe and of the big toe nail in only one operative stage. The technique of leaving the pedicle exteriorized during transplantation (autonomization) facilitates positioning of the nail onto the recipient site and eliminates subsequent problems of commissural retraction.

• Authors: F Brunelli, G R Brunelli, R Perrotta
• Journal: Annales de chirurgie de la main et du membre superieur : organe officiel des societes de chirurgie de la main = Annals of hand and upper limb surgery (Ann Chir Main Memb Super) Vol. 11 Issue 5 Pg. 411-5 ( 1992) ISSN: 1153-2424 [Print] France
• PMID: 1284024 (Publication Type: Case Reports, Journal Article)

Topics

• Amputation, Traumatic (surgery)
• Child, Preschool
• Female
• Finger Injuries (surgery)
• Hand (surgery)
• Humans
• Nails (transplantation)
• Orthopedics (methods)
• Toes (transplantation)