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J Reconstr Microsurg 2004; 20(3): 215-225
DOI: 10.1055/s-2004-823109
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Microsurgical Second Toe-Metatarsal Bone Transfer for Reconstructing Congenital Radial Deficiency with Hypoplastic Thumb

Yuan-Kun Tu1 , Wen-Lin Yeh1 , Kanit Sananpanich2 , Steve Wen-Neng Ueng1 , Ying-Chao Chou1 , Ching-Hou Ma1 , Zhon-Liau Lee1
  • 1Department of Orthopedics, Chang Gung Memorial Hospital, Linkou, Taiwan
  • 2Department of Orthopedics, Chiangmai University, Chiangmai, Thailand
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Publication History

Accepted: 2 December 2003

Publication Date:
16 April 2004 (online)

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This study describes a consecutive series of 11 children who received a microsurgical second toe-metatarsal bone transfer for reconstructing a hypoplastic thumb associated with radial club hand, between 1996 and 2000. The parents refused pollicization in all cases for aesthetic and cultural reasons. Surgery was intended to improve hand function and cosmetic appearance. The average patient age was 3 years, and the average follow-up period was 4 years. Average surgery time for the second toe-metatarsal bone transplantation was 8 hr. The primary success rate was 90.9 percent, with one patient requiring repeat surgery owing to venous occlusion. The surgical outcomes reveal a normal growth of the transferred toe, an acceptable range of motion, and satisfactory recovery of sensation. All children achieved both small and large grasp functions. The parents were satisfied with the reconstruction procedures. Based on the preliminary results, second toe-metatarsal bone transfer appears an acceptable alternative for reconstructing radial deficiency with hypoplastic thumb.

KEYWORDS

Radial club hand - hypoplastic thumb - second toe-metatarsal bone flap - microsurgical toe transfer

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Zhon-Liau LeeM.D. 

Department of Orthopedics, Chang Gung Memorial Hospital

Linkou, No. 5 Fu-Hsin Road

Kwei-Shan, Tao-Yuan, Taiwan