Page 75 - Microsurgery

Sources for Donor Joint Transfers

The donor joint for transfer can be harvested either from a finger or a toe.

1. From a Finger:

 Pedicled heterodigital transfers of MCP or PIP joints.

 Homodigital transfer: DIP to PIP joint (Foucher technique).

 Microvascular heterodigital joint transfer.

2. From a Toe:
The technique for toe transfers has been clearly established since the initial
descriptions by Buncke and Cobbett, who performed the first human toe transfer via
microsurgery. Transfers may involve either the metatarsophalangeal or
interphalangeal joint for reconstructing a damaged joint.

Transfers of double toe joints as well as partial transfers have also been described.

Patient motivation is crucial when considering a toe transfer. Sacrificing the second toe can
be psychologically distressing. However, mutilation can be avoided by performing an
arthrodesis, inserting an iliac crest bone graft to replace the donor joint.

The issue of limited extension post-transfer is particularly challenging. It should be noted
that tenolysis or subsequent tendon transfers can enhance the mobility of these joint
transfers.

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