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

Utilisation des « tissus-banque » en chirurgie de la main d’urgence

“…Le segment amputé peut fournir une greffe osseuse conventionnelle, un tissu osseux vascularisé sous forme libre ou pédiculé pour restaurer la longueur osseuse des segments conservés [7].…”

Post-traumatic reconstruction of digital joints by costal cartilage grafting: A preliminary prospective study

“…In some other cases, amputation is considered but such intervention must be discussed together with the patient so as to obtain his (her) informed consent. Techniques that preserve mobility have been carried out as secondary options; they include: volar plate arthroplasty [1], vascularized or non vascularized joint transfers [2,3], resections-distractions [4,5], and salvage interventions [6]. Emergency resections-arthroplasties with implant insertion [7][8][9][10], such as Swanson's implant, provide good outcome with arcs of motion reaching 428 for the PIP joint [7].…”

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).…”

“…8 Various authors have since presented their series, further supporting the efficacy of this technique. [6][7][8][9] In addition, Hierner and Berger and Mishra et al [6][7][8][9][10][11] independently demonstrated that ROM achieved with heterotopic vascularized joint transfer was equal or greater than that compared with toe joint transfer. However, although several papers have described the technique and its outcomes, there is little discussion or analysis of the strategies involved in executing the technique.…”