Free Compound Transfer of the Distal Interphalangeal Joint: A Case Report

Abstract

The first case of free vascularized transfer of a distal interphalangeal (DIP) joint, used to replace a severely damaged proximal one, is presented. The case is interesting not only for the procedure used, but it also illustrates the principle by which useful components of nonsalvageable digits are used to reconstruct other damaged, but still salvageable, parts of the hand.

Free vascularized joint transfer from the nonreplantable digit as a free flap for primary reconstruction of complex hand injury

“…Foucher et al 4 reported a successful case using the distal interphalangeal joint of a nonreplantable digit to replace the severely damaged PIP joint of another digit. The active range of motion of the reconstructed PIP joint was 65°.…”

Les transferts articulaires pédiculés au niveau des doigts

“…La main est le site donneur idéal et deux techniques sont disponibles en urgence comme en chirurgie secondaire : le transfert hétérodigital (en îlot ou libre) à partir d'un doigt banque [10][11][12] ; le transfert homodigital (IPD sur IPP en îlot) le doigt blessé étant utilisé comme doigt banque [10].…”

“…La difficulté technique comme le risque de thrombose sont comparables à celles d'une réimplantation microchirurgicale [11].…”

“…En présence d'une destruction articulaire étendue, de nombreuses techniques ont été proposées : [4,10,11,18,19].…”

Heterotopic Vascularized Joint Transfer in Mutilating Hand Injuries

“…Therefore, when PIPJs or MPJs are severely damaged on otherwise salvageable digits, heterotopic vascularized joint transfer can be a valuable option to improve long-term outcomes. [7][8][9] In 1967, Buncke et al 10 first reported this technique, when he transplanted a free MPJ from index finger to reconstruct the destructed MPJ of middle finger. This was successful and the patient achieved nearly 90°of active range of motion (ROM).…”