Carbullido M Kristine, Zona Emily E, Thornton Sarah M, Attaluri Pradeep, Wirth Peter J, Shaffrey Ellen C, Rao Venkat K
Division of Plastic and Reconstructive Surgery University of Wisconsin School of Medicine and Public Health, Madison, WI.
J Hand Surg Glob Online. 2024 Dec 19;7(2):242-245. doi: 10.1016/j.jhsg.2024.11.012. eCollection 2025 Mar.
Replantation of damaged digits is the preferred treatment for traumatic pediatric hand injuries, but, when replantation is not feasible, second toe-to-hand transfers have been reported since the 1960s as a reconstructive method. This case report discusses a 38-year follow-up of a pediatric patient who underwent bilateral second toe-to-hand transfer after a riding lawn mower accident resulted in traumatic amputations of her right index through little fingers. At follow-up, the patient's hand was assessed for functionality, including range of motion, grip strength, and sensation. The Disabilities of the Arm, Shoulder, and Hand score was 0/100, and 2-point discrimination was 7 mm, indicating high functionality and quality of life. No donor site complications were reported, and the patient actively participated in sports and recreational activities. This case demonstrates that toe-to-hand transplants can restore significant hand function with minimal complications.
对于小儿手部创伤，受损手指再植是首选治疗方法，但当再植不可行时，自20世纪60年代以来，第二足趾移植到手已被报道作为一种重建方法。本病例报告讨论了一名儿科患者的38年随访情况，该患者在骑乘割草机事故导致右手示指至小指外伤性截肢后接受了双侧第二足趾移植到手。在随访时，对患者手部的功能进行了评估，包括活动范围、握力和感觉。上肢、肩部和手部功能障碍评分0/100，两点辨别觉为7毫米，表明功能和生活质量较高。未报告供区并发症，患者积极参与体育和娱乐活动。本病例表明，足趾移植到手可恢复显著的手部功能，且并发症最少。
