Download PDF
CC BY-NC-ND 4.0 · Indian J Plast Surg 2021; 54(03): 367-369
DOI: 10.1055/s-0041-1735718
Case Report

Functional Restoration of a Midforearm Level Amputation using the Second Toe Transfer

Mohit Sharma
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, India
,
K. S. Shravan Rai
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, India
,
G. Srilekha Reddy
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, India
,
Shruti Kongara
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Kochi, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Unilateral midforearm level amputation is a severely debilitating situation. The present solution for this problem is either restoration of function using a prosthetic hand, or a vascularized composite allotransplant (VCA) in some very selected cases. In cases of distal forearm level amputations, even vascularized second toe transfer could be done on the radial side of the hand to achieve good functional restoration. We present a case of midforearm level amputation in which the second toe transfer has been done above the level of insertion of pronator teres muscle to achieve meaningful function. This report highlights the fact that a single toe transfer could be helpful in achieving meaningful prehension, even at this proximal.

Keywords

forearm amputation - toe transfer - Vilkki procedure


Publication History

Article published online:
13 October 2021

© 2021. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Dominique M, Katarina W. The Vilkki Procedure as an emergency treatment in an apocalyptic hand injury-a case report and first description. Case Reports Plast Surg Hand Surg 2017; 4 (01) 96-98
    CrossrefPubMedGoogle Scholar
  • 2 Vilkki SK. Toe to antebrachial stump transplantation. Functional results after new grip reconstruction. In: Brunelli G, ed. Textbook of Microsurgery Masson 1988: 329-333
  • 3 Vilkki SK. Grip reconstruction with toe to antebrachial stump transfer. In: Landi A, ed. Reconstruction of the Thumb London 1989: 233-241
  • 4 Kallio KE. Recent advance in Krukenberg’s operation. Acta Chir Scand 1948; 97: 165-188
    Google Scholar
  • 5 Vilkki SK. [Free toe transfer to the forearm stump following wrist amputation–a current alternative to the Krukenberg operation]. Handchir Mikrochir Plast Chir 1985; 17 (02) 92-97
    PubMedGoogle Scholar
  • 6 Vilkki SK, Kotkansalo T. Present technique and long-term results of toe-to-antebrachial stump transplantation. J Plast Reconstr Aesthet Surg 2007; 60 (07) 835-848
    CrossrefPubMedGoogle Scholar
  • 7 Borovikov A. Toe-to-hand transfers in the rehabilitation of frostbite injury. Ann Plast Surg 1993; 31 (03) 245-250
    CrossrefPubMedGoogle Scholar
  • 8 Hettiaratchy S, Butler PE, Lee WP. Lessons from hand transplantations. Lancet 2001; 357 (9255) 494-495
    CrossrefPubMedGoogle Scholar
  • 9 Michael E, Neil HM, Alastair P. History and ethics of hand transplants. J R Soc Med Sh Rep 2012; 3 (10) 74
    PubMedGoogle Scholar