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Journal of Hand Surgery (British and European Volume)
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Articles

Long Term Follow-Up of Composite Non-Vascularized Toe Phalanx Transfers for Aphalangia

M. A. TONKIN
A. K. DEVA
S. L. FILAN

From the Department of Hand Surgery and Peripheral Nerve Surgery, University of Sydney, Royal North Shore Hospital, Sydney, Australia

Correspondence: Prof Michael A Tonkin, Department of Hand Surgery and Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards NSW 2065, Australia. Tel.: +61 2 9926 7778; fax: +61 2 9926 7774. E-mail: mtonkin{at}surgery.usyd.edu.au

The results of 21 non-vascularized toe phalanx transfers in 13 patients were reviewed radiologically with respect to function, physeal patency, growth and donor site morbidity at a mean follow-up of 7.4 (range 2.9–13.6) years. Physeal patency was maintained in 4 of 18 surviving transfers. The length of the transferred phalanx averaged 75% of the contralateral comparable toe phalanx and 44% of the contralateral digit proximal phalanx. Most patients had good or simple use of the hand with active joint motion. There was universal shortening of the donor toe with hypoplasia of the middle and distal phalanges. This review suggests that transfer of a non-vascularized toe phalanx provides a reliable but limited means for increasing length of a digit, stabilizing soft tissue "nubbins" and improving function. Longer follow-up has shown more modest gains in growth than in some previous reports.

Key Words: congenital anomalies • toe phalanx • aphalangia

Journal of Hand Surgery (British and European Volume), Vol. 30, No. 5, 452-458 (2005)
DOI: 10.1016/j.jhsb.2005.06.001
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