Page 76 - Microsurgery

Indications for joint transfers

Indications for joint transfers include emergency salvage operations, where a donor finger
may be used to reconstruct either a metacarpophalangeal or an interphalangeal joint. As will
be illustrated, a traumatized index finger can serve as a "bank finger."

Regarding reconstruction techniques, joint transfers can be performed as either pedicled or
free flaps at the metacarpophalangeal joint level. At the proximal interphalangeal joint, a
pedicled island flap using Foucher's technique may be performed, involving a vascularized
distal interphalangeal joint pedicled on one of the two collateral arteries.

In free flap transfers, an amputated finger may be utilized to transfer a proximal
interphalangeal joint, as described later.

Joint transfers from toes may also be performed, either preserving or sacrificing the donor
toe.

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