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Reconstruction of Fingertip Amputations by Partial Composite Toe Transfer with Short Vascular Pedicle

From the "Service SOS Mains", Hôpital d’Enfants, CHU Brabois, Nancy, France

Correspondence: G. Dautel MD, 79 boulevard Foch, 54520 Laxou, France.

Five patients under 15 years-of-age, with a fingertip amputation through the nail plate, were treated with a custom-made partial toe transfer. Two of the patients hid had previous attempts at surgical reconstruction using either a local flap or replantation. Delay between initial injury and reconstruction ranged from 2 to 60 days. In all cases the flap was harvested from the second toe. This "custom-made" compound transfer included the exact amount of pulp, nail bed and bone required for reconstruction. All flaps were harvested on a short vascular pedicle, with anastomoses performed at a digital level on the recipient site. Good to excellent cosmetic results were obtained in all cases, with a nearly normal-looking fingertip. Duration of hospital stay ranged from 4 to 7 days. We recommend this technique for treatment of distal amputation close to the proximal nail fold, in young individuals.

Journal of Hand Surgery (British and European Volume), Vol. 23, No. 4, 457-464 (1998)
DOI: 10.1016/S0266-7681(98)80122-8


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