Simultaneous reconstruction of extensor mechanism in the free transfer of vascularized proximal interphalangeal joint.

摘要: From a recent systemic review, vascularized toe proximal interphalangeal joint (PIPJ) transfer achieved an average arc of motion (AOM) merely 37 degrees for finger PIPJ reconstruction. Despite the technical refinement over past 3 decades, resulting active reconstructed remains unpredictable and often fraught with extension lag. The technique at our institute has evolved years to its current state, simultaneous extensor mechanism reconstruction being major component. During transfer, quality tendons on recipient donor are carefully evaluated. If central slip is destroyed but lateral bands adequate, centralization overlying transferred performed. there acceptable remnant phalanx level, modified Stack procedure performed while leaving in continuity. both poor, unless tendon strong enough extend PIPJ. November 2008 October 2010, 7 joints were this technique. follow-up was 18.2 months. AOM 56.4 degrees. lag 10.7 16.4 before after respectively. Simultaneous decreases without sacrificing