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. 2022 May 31;59(4):e632-e636.
doi: 10.1055/s-0042-1744518. eCollection 2024 Aug.

Transfer of Second Toe for the Treatment of Traumatic Thumb Amputation in a Four-year-old Child: A Case Report

Hugo Alberto Nakamoto  1 , Reinaldo Borges Gonçalves  1 , João Carlos Nakamoto  1 , Fernanda do Carmo Iwase  1 , Mariana Miranda Nicolosi Pessa  1 , Marcelo Rosa de Rezende  1
Affiliations

Transfer of Second Toe for the Treatment of Traumatic Thumb Amputation in a Four-year-old Child: A Case Report

Hugo Alberto Nakamoto et al. Rev Bras Ortop (Sao Paulo). .

Abstract

Microsurgical toe transfer for thumb reconstruction is a challenging procedure, considering the technical skills necessary to perform it, as well as the difficult postoperative evaluation of esthetical and functional aspects. The present is the report of the case of a 3-year-old child who suffered a traumatic thumb amputation. Thumb reconstruction was performed through microsurgical toe transfer months after replantation failure. Subjective and objective outcome assessments were performed five years after the procedure. The functional outcome was evaluated through the Childhood Health Assessment Questionnaire (CHAQ) and the Jebsen-Taylor Hand Function Test (JTHFT). The Jamar dynamometer (Sammons Preston, Bolingbrook, IL, US) and the Jamar Pinch Gauge (Sammons Preston) devices were used to assess the handgrip and pinch strength respectively. The Semmes-Weinstein monofilament and two-point discrimination tests were performed. The patient presented an excellent functional outcome, partial recovery of strength, complete sensory recovery, and minimal donor site morbidity. A radiographic evaluation was also performed, and it demonstrated the preservation of the epiphyseal plate and the growth potential of the transplanted toe. In all aspects, the data observed reinforce the benefits and indications of toe transfer for thumb reconstruction in children.

Keywords: amputation, traumatic/surgery; child; thumb; toes/transplantation.

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Conflict of interest statement

Conflito de Interesses Os autores declaram não haver conflito de interesses.

Figures

Fig. 1
Fig. 1
Planning of the hand incision.
Fig. 2
Fig. 2
Planning of the foot incision.
Fig. 3
Fig. 3
Immediate postoperative outcome.
Fig. 4
Fig. 4
Esthetic and functional late postoperative outcome.
Fig. 5
Fig. 5
Radiograph of the right hand and foot, under the same magnification, with a comparative measure of the length of the proximal phalanx.
Fig. 1
Fig. 1
Planejamento da incisão da mão.
Fig. 2
Fig. 2
Planejamento da incisão do pé.
Fig. 3
Fig. 3
Resultado pós-operatório imediato.
Fig. 4
Fig. 4
Resultado pós-operatório estético e funcional tardio.
Fig. 5
Fig. 5
Radiografia da mão e pé direitos, sob a mesma ampliação, com medida comparativa do comprimento da falange proximal.
See this image and copyright information in PMC

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