Toe-to-Hand Transfer in Symbrachydactyly

Richardson, P.; Johnstone, Brian M.; Coombs, Christopher J.

doi:10.1142/s0218810404001929

Cited by 21 publications

(12 citation statements)

References 24 publications

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“…Yoshimura [42] reported 33 pediatric toe transfers in 28 children, 2 of whom had congenital anomalies—one child had an absent thumb, index, and middle fingers and the second child had congenital constriction ring syndrome. After other case reports [24, 27], several surgeons have reported larger series of microsurgical toe-to-hand transfers to reconstruct various congenital anomalies of the hand [3, 10–13, 15, 17–20, 30, 31, 36, 37].…”

Section: Resultsmentioning

confidence: 99%

Indications for Microsurgical Reconstruction of Congenital Hand Anomalies by Toe-To-Hand Transfers

Kaplan

2013

Hand (New York, N,Y.)

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Background The indications for microsurgical toe-to-hand transfers in congenital hand surgery have not been defined as clearly as for posttraumatic reconstruction of thumb and finger amputations. The purpose of this study was to develop simple guidelines for referral of children with congenital absent digits for consideration of microsurgical reconstruction with toe-to-hand transfers, based on the morphological or radiographic anatomy of the hand anomaly, not on embryological classifications. Methods From a consecutive series of 204 children referred with congenital absence of the thumb and fingers, 100 toe-tohand transfers were performed. The indications for microsurgical reconstruction of these children were analyzed retrospectively. Results Forty-one thumbs were reconstructed in 38 children-15 children with an absent thumb distal to the metacarpal base but with four relatively normal fingers; 12 children with an absent thumb and only one or two digits remaining on the ulnar side of the hand; and 11 children with complete absence of all five digits. Twenty-nine second toes and 12 great toes were transferred to reconstruct congenital absent thumbs. Fifty-nine fingers in 52 children were reconstructed mostly with single second toe transfers-41 children with a thumb but absence of all four fingers and 11 children with absence of all five digits. Conclusions The morphological or radiographic anatomy of a child's hand with congenital absent digits is a more logical indication for microsurgical reconstruction than any embryological classification. The three most common indications for toe transfers for reconstruction of congenital absent thumbs are (1) absent thumb distal to the carpometacarpal joint with four relatively normal fingers, (2) absent thumb with only one or two fingers remaining on the ulnar border of the hand, and (3) complete absence of the thumb and all four fingers. The two indications for toe transfers for reconstruction of congenital absent fingers are (1) absence of all four fingers but with a normal thumb remaining and (2) complete absence of all five digits.

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Section: Resultsmentioning

confidence: 99%

Indications for Microsurgical Reconstruction of Congenital Hand Anomalies by Toe-To-Hand Transfers

Kaplan

2013

Hand (New York, N,Y.)

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“…At 5-year follow-up, range of motion (ROM) was adequate, and most participants reported that they used the affected hand in daily activities. In 2004, Richardson 53 described the results of 18 free toe transfers in 13 patients with symbrachydactyly. The results of a bimanual hand function questionnaire indicated that 61% could lift a cup, 54% could button, 38% could cut paper, and 30% could use a knife and fork; 85% of parents were happy with the appearance of the hand and 77% were happy with the function of the hand.…”

Section: Syndactyly and Web Contracturementioning

confidence: 99%

“…Others have reinforced that there is a wide variation in the neurovascular structures in symbrachydactyly. 35,40,53 In 2001, Foucher 18 reported on 51 toe transfers in 45 patients with symbrachydactyly. Transfers to types IIIA and IIIB were the most common, followed by type IVA.…”

Section: Syndactyly and Web Contracturementioning

confidence: 99%

Symbrachydactyly

Goodell

Bauer

Sierra

et al. 2016

Hand (New York, N,Y.)

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Background: Symbrachydactyly is a unilateral congenital hand malformation characterized by failure of formation of fingers and the presence of rudimentary digit nubbins. The management is variable and are investigated in this review. Methods: a detailed review of the literature was compiled into succinct clinically relevant categories. Results: Etiology, classification, non-surgical management, surgical intervention, and patient oriented outcomes are discussed. Conclusions: all interventions should prioritize realistic, evidence-supported appearance and functional gains. Studies of the baseline function and quality of life of children with symbrachydactyly would allow surgeons to better understand functional changes associated with various interventions and would help surgeons and parents to make the best treatment decisions.

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“…Congenital thumb absence, constriction ring syndrome, and symbrachydactyly are now potential indications for toe-hand transfer in order to restore sensate pinch. (18-19) Although early attempts were met with concern for epiphyseal disruption and premature closure, more recent series indicate that toes transferred to the hand in children can reach up to 100% length of the contralateral toe and with normal growth. (20)…”

Section: Evolving Indicationsmentioning

confidence: 99%

Toe-to-Hand Transfer: Evolving Indications and Relevant Outcomes

Waljee¹,

Chung²

2013

The Journal of Hand Surgery

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In the late 19th century, the first toe to hand transfer was performed in Vienna, Switzerland as a staged procedure by Nicolandi.(1) Since that time, the advent of microsurgery has revolutionized toe to hand transfers. In 1966, Buncke performed the first microvascular toe to thumb transfer in a rhesus monkey.(2) The first toe to thumb transfer using microsurgical techniques in humans was performed by Cobbett in 1969, followed shortly thereafter by the first transfer of a second toe to the thumb position.(3,4) Today, due to expanding microsurgical techniques and surgeon innovation, the indications and techniques for toe-to-hand transfer procedures continue to evolve and now encompass patients with a variety of acquired and congenital hand defects.(5)

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Toe-to-Hand Transfer in Symbrachydactyly

Cited by 21 publications

References 24 publications

Indications for Microsurgical Reconstruction of Congenital Hand Anomalies by Toe-To-Hand Transfers

Indications for Microsurgical Reconstruction of Congenital Hand Anomalies by Toe-To-Hand Transfers

Symbrachydactyly

Toe-to-Hand Transfer: Evolving Indications and Relevant Outcomes

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