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Second Toe (second + toe)
Selected AbstractsCompound flap from the great toe and vascularized joints from the second toe for posttraumatic thumb reconstruction at the level of the proximal metacarpal boneMICROSURGERY, Issue 3 2009Tsu-Min Tsai M.D. The purpose of this study is to describe the harvesting technique, anatomic variations, and clinical applications of a compound flap from the great toe and vascularized joint from the second toe used for thumb reconstruction. Five fresh cadaver dissections were studied, focusing attention on the dorsal or plantar vascular dominance, position of the communicating branch between the dorsal and plantar system, the Gilbert classification, and the size of the first dorsal metatarsal artery (FDMA) and first plantar metatarsal artery (FPMA) to the great toe and second toe. Five compound flaps were performed on five patients with traumatic thumb amputation at the level of proximal metacarpal bone. The patients' ages ranged from 14 to 47. Follow-up period was 11,24 months. The anatomic study showed that FPMA had larger caliber in 40% of dissections, FDMA in 40%, and had the same caliber in 20%. The Gilbert classification of FDMA was 40% class I and 60% class III. In the clinical applications, four patients achieved good functional opposition and motion of transferred joints with good pinch and grip strength. There was one flap failure, and donor-site morbidity was minimal. The compound flap offers advantages over traditional toe transfer by providing two functional joints. It can be used for amputation of the thumb at carpometacarpal joint level. Finally, the compound flap maintains growth potential in children through transfer of vascularized epiphyses. The disadvantages of this compound flap include a technically challenging harvest and a longer operative time. © 2008 Wiley-Liss, Inc. Microsurgery, 2009. [source] Microsurgical treatment for bilateral thumb defect: Five case reportsMICROSURGERY, Issue 6 2003Lei Xu M.D., Ph.D. The authors present a new and efficient treatment for reconstruction of bilateral defective thumbs by different configured toe-tissuestransplantations in a single stage, including bilateral second-toe transfer in 2 cases, bilateral hallux wrap-around flap transfer in 1 case, bilateral modified hallux wrap-around flap transfer in 1 case, and combined second toe with island flap with neurovascular pedicles from the proximal and dorsal aspect of the index finger transfer in 1 case. In total, eight transferred tissues survived uneventfully after circulation monitor and medicine administration according to the rules of microsurgery, and in two other transferred toe tissues, temporary circulation crises occurred. Over a 1-year follow-up, the satisfactory appearance and excellent function of the reconstructed bilateral thumbs were noted. For ensuring the success of the procedure, the authors emphasize the establishment of a double artery supply and venous return-flow systems and the modification of the hallux wrap-around flap dissection and tendon repair. Meanwhile, three-stage systemically functional rehabilitations also improved functional restoration of reconstructed thumbs. © 2003 Wiley-Liss, Inc. MICROSURGERY 23:547,554 2003 [source] A reconstructed digit by transplantation of a second toe for control of an electromechanical prosthetic handMICROSURGERY, Issue 1 2002Zhong Wei Chen M.D. The treatment options for the loss of an entire human hand and part of the forearm are currently limited to the transplantation of toe(s) to the amputation stump or a Krukenberg's bifurcation hand, and using a cosmetic or functional prosthesis. The functional prosthetic hand, such as the prevailing myoelectrically controlled prosthetic hand, has an action accuracy that is affected by many factors. The acceptance rate of the three planes freedom myoelectronic hand by the patients was 46,90% because of poor function caused by the weakness of signal and strong external interference. In this report, the left second toe was transplanted to the patient's forearm amputation stump. Mandates from the brain are relayed by the action of this reconstructed digit, to control a special designed multidimension freedom electronic prosthetic hand. After rehabilitation and adaptation training, the correct recognition rate of the electronic prosthetic hand controlled by this reconstructed digit is a remarkable 100%. © 2002 Wiley-Liss, Inc. MICROSURGERY 22:5,10, 2002 DOI 10.1002/micr.22002 [source] HS07 TOE TRANSFER , TECHNIQUES & RESULTSANZ JOURNAL OF SURGERY, Issue 2007L. C. Teoh Toe to thumb-finger transfer requires the understanding of microsurgery and reconstructive technique. The success is measured by the viability of the toe and eventually recreating the function of the original loss. In harvesting of the toe, the big and second toe follows almost the same technique. Identifying the toe artery over the first web space and then dissecting proximally into the intermetatarsal artery is the best approach. To dissect the artery from proximal to distal is often fraught with many dangers. In my cases about 50% the plantar artery is dominant. Anticipation and planning of the artery length is crucial. In toe to thumb transfer the choice can be 2nd toe, total big toe, trimmed big toe or wrap around transfer. In our local populations, 2nd toe is always a good choice. First reconstruction with flap resurfacing may be necessary if the thumb amputation is very proximal. Toe to fingers transfer is usually indicated in 4 finger loss of the hand. In toe to finger transfer I prefer the two 2nd toes transfer into the middle and ring finger position. As the transferred toes can regain less that 50% of motion, the positioning of the toes should be opposable to the thumb. The concept of total reconstruction should be closely followed. Stable skeletal fixation, tendon weave technique, good nerve repair, adequate skin coverage and primary healing are important to ensure good outcome result. [source] Subungual and periungual congenital blue naevusAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2009Platina Coy Gershtenson ABSTRACT Subungual pigmented lesions should raise concern about malignant melanoma. Blue naevus of the nail apparatus is a rare entity, with only ten cases described in the literature. We report a 21-year-old Hispanic woman with a slowly enlarging 1.7 × 2.3-cm subungual and periungual pigmented plaque present since birth on her right second toe. Initial biopsy was consistent with a blue naevus of the cellular type and, given the recent clinical change and periungual extension, complete excision was recommended. The entire nail unit was resected down to periosteum with prior avulsion of the nail plate. Reconstruction was performed with a full-thickness skin graft. Follow up at 1 year revealed well-healed graft and donor sites with complete return of function. We present a case of a congenital subungual and periungual blue naevus of the cellular type and review the literature on this rare presentation of a congenital blue naevus. [source] | ||||||||||