Article

Complete destruction of the PIP or MCP joint space can be treated by a
vascularized transfer from the foot in selected patients. The surgical technique
for PIP and MTP vascularised transplantation is described with special emphasis
on recent improvements (use of a short vascular pedicle, refinements in donor
site reconstruction). Results of a series of 50 transfers performed between 1992
and 2009 are presented.
PIP transfer was performed in 37 patients, at an average
age of 18.3 years (range 3 to 40) leading to an average active ROM of 44 degrees
(0-80), with a lag of extension of 34.2 degrees (0-80). MCP transfer was
performed in 12 patients (13 transfers), at an average age of 21.3 years (range 3
to 40) leading to an average range of motion of 60 degrees (35-80), with a lag of
extension of 18.6 degrees (0-30). None of the reconstructed articulations was
painful. On the plain radiographs, no degradation of the joint space of the
transferred articulations was noted. Within the pediatric population, the growth
potential was preserved, signing the perenniality of the vascularization of the
transfers. When faced to a complete joint destruction involving either the PIP or
the MCP of the long fingers, reconstruction can be achieved by the mean of a
vascularized joint transfer. The range of motion obtained with these transfers is
not superior to what is observed after arthroplasty but it will persist with time. Therefore, even it is a technically demanding option, it should remain in
our armamentarium as an alternative to joint fusion or joint arthroplasty.
CI - Copyright (c) 2010. Published by Elsevier SAS.

Langue : FRANCAIS