Publication
Free Non-vascularized Toe Phalangeal Transfers in Symbrachydactyly: Outcome Analysis
| dc.contributor.author | Sapage, Rita | |
| dc.contributor.author | Rosa, João | |
| dc.contributor.author | Campos Pereira, Eva | |
| dc.contributor.author | Silva, Marta Santos | |
| dc.contributor.author | Pereira, Alexandre | |
| dc.contributor.author | Silva, César | |
| dc.date.accessioned | 2021-12-02T16:39:09Z | |
| dc.date.available | 2021-12-02T16:39:09Z | |
| dc.date.issued | 2020-07-27 | |
| dc.description.abstract | Free nonvascularized toe phalangeal transfer is an established surgical option for the reconstruction of hypoplastic digits. The purpose of the present study was to evaluate our experience with this procedure and to assess bone growth and digit function as well foot morbidity. Material and Methods We retrospectively evaluated the clinical records for all children with symbrachydactyly submitted to free nonvascularized toe phalangeal transfer between 2002 and 2017. A total of 8 patients were included. We summoned the patients to na appointment to clinically assess the range ofmotion, the stability, and the alignment of the neo-joint. We radiographically measured the final length and the expected percentage of growth of the transferred phalanx. We also evaluated the foot for comorbidities. Results The mean age at the time of the first surgery was 19 months (range: 8–42 months). A total of 20 phalanges were harvested: 16 total proximal phalanges, 2 middle phalanges, 1 subtotal proximal phalanx, and 1 accessory thumb phalanx. The distal part of one proximal phalanx was trimmed because the skin pocket was too tight. Two patients underwent a secondary procedure to release the syndactyly. One transfer required revision surgery due to distal tip necrosis and exposition of the transferred phalanx. In the present series, the overall clinical and radiographic outcomes were compatible to those reported in other studies. Discussion The main limitation of the nonvascularized toe phalanx transfer is the preexisting soft tissue envelope of the finger and the limited growth potential of the transferred bone. Conclusion Irrespective of the amount of growth achieved in the transferred phalanx, the actual transfer and growth attained should not be viewed as the end result, but rather as a means of providing a stable and functional joint. | pt_PT |
| dc.description.abstract | La transferência no vascularizada y libre de la falange del pie es una opción quirúrgica establecida para la reconstrucción de dedos hipoplásicos. El objetivo de este estudio fue analizar nuestra experiencia con este procedimiento y evaluar el crecimiento óseo y la función digital, así como la morbilidad del pie. Material y Métodos Analizamos retrospectivamente el proceso clínico de los niños (n ¼ 8) con simbraquidactilia que se sometieron a una transferencia no vascularizada y libre de la falange del pie entre 2002 y 2017. Hicimos una consulta para evaluar clínicamente el rango de movilidad, la estabilidad, y la alineación de la nueva articulación. Medimos la longitud final y el porcentaje de crecimiento esperado de la falange transferida. Evaluamos el pie para la comorbilidad. Resultados La edad media al momento de la cirugía fue de 19 meses (rango: 8–42 meses). Se recogieron un total de 20 falanges: 16 falanges proximales totales, 2 falanges medianas, 1 falange proximal subtotal, y 1 falange accesoria del pulgar. La parte distal de una falange proximal se sacrificó porque la envoltura de la piel estaba demasiado apretada. Dos pacientes se sometieron a un procedimiento secundario por la liberación de sindactilia. Una transferencia requirió revisión debido a la necrosis de la porción distal y la exposición de la falange transferida. En la presente serie, los resultados clínicos y radiográficos generales fueron compatibles con los descritos por otros estudios. Discusión Las principales limitaciones de la transferencia no vascularizada y libre de las falanges del pie son la envoltura preexistente de tejidos blandos y el potencial de crecimiento limitado del hueso transferido. Conclusión Independientemente del crecimiento obtenido con la transferencia de la falange, esto no debe verse como el resultado final, sino como un medio paramejorar la estabilidad y la funcionalidad de la nueva articulación. | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | Rev Iberam Cir Mano 2020;48:87–92. | pt_PT |
| dc.identifier.doi | 10.1055/s-0040-1718456 | pt_PT |
| dc.identifier.issn | 1698-8396 | |
| dc.identifier.uri | http://hdl.handle.net/10400.26/38168 | |
| dc.language.iso | eng | pt_PT |
| dc.publisher | Thieme Open Access | pt_PT |
| dc.subject | digital hypoplasia | pt_PT |
| dc.subject | reconstruction | pt_PT |
| dc.subject | symbrachydactyly | pt_PT |
| dc.subject | toe phalanges | pt_PT |
| dc.subject | reconstrucción | pt_PT |
| dc.subject | Portugal | pt_PT |
| dc.subject | Região Autónoma da Madeira | pt_PT |
| dc.subject | simbraquidactilia | pt_PT |
| dc.subject | dedos hipoplásicos | pt_PT |
| dc.title | Free Non-vascularized Toe Phalangeal Transfers in Symbrachydactyly: Outcome Analysis | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 92 | pt_PT |
| oaire.citation.issue | 02 | pt_PT |
| oaire.citation.startPage | 87 | pt_PT |
| oaire.citation.title | Revista Iberoamericana de Cirugía de la Mano | pt_PT |
| oaire.citation.volume | 48 | pt_PT |
| person.familyName | Campos Pereira | |
| person.givenName | Eva | |
| person.identifier.orcid | 0000-0002-8117-0946 | |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |
| relation.isAuthorOfPublication | 19ab12ec-1c27-4833-a871-3750802ba288 | |
| relation.isAuthorOfPublication.latestForDiscovery | 19ab12ec-1c27-4833-a871-3750802ba288 |
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