gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Aspects of toe to hand transfers in children with the macrodactyly of the hand

Meeting Abstract

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  • presenting/speaker Tatiana Tikhonenko - The Turner Institute For Childrens Orthopedics, Pushkin, Russia
  • Sergey Golyana - The Turner Institute For Childrens Orthopedics, Pushkin, Russia

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1572

doi: 10.3205/19ifssh1374, urn:nbn:de:0183-19ifssh13740

Published: February 6, 2020

© 2020 Tikhonenko et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: Purpose of the study is to determine the role of microsurgical toe to hand transfer in the treatment of children with isolated macrodactyly, based on a comparative analysis of various types of surgical interventions

Methods: In the department of reconstructive microsurgery from 2013 to 2017, 25 children with congenital macrodactyly of the hand were examined and surgically treated. Out of 25 patients, in 13 there was a macrodactyly of the 2nd, 3rd fingers, which was 52%. At the same time, of the total number of hyperplastic hand segments (n = 45), 17 rays had hyperplasia greater than 25%.

Results and Conclusions: Stage-by-stage modeling resections of enlarged segments were performed in all children with hyperplasia of the ray of about 25% of the size of intact fingers, in 4 cases excision of soft tissues was combined with marginal resection of phalanges. When hyperplasia of the segment reached up to 10% of macrodactyly, it was performed in the child the single isolated modeling resections of soft tissues and bones. Repeated modeling operation in 16% (n = 4) children were accompanied by the formation of gross postoperative scars with the development of secondary angular deformities and loss of functions of interphalangeal joints.

9 patients (n = 14) underwent amputation of hyperplastic fingers followed by microsurgical reconstruction of rays by the method of autografting of the toes. In 4 cases, the first finger was reconstructed. In other 5 cases, two toes of both feet were transplanted to the position of 2, 3 (n = 4) and to the position of 3, 4 fingers (n = 1). It was revealed that with a significant hyperplasia of the affected segments of the hand (1.5 - 2 times), the method of microsurgical autografting of the toes is more effective and acceptable compared to the method of bone and soft tissue resections.

With segment hyperplasia less than a quarter of the normal size, the optimal surgical interventions are stage by stage modeling resection.;

An alternative method of surgical treatment of children with hyperplasia of more than 25% is microsurgical transplantation of the toes into the position of the involved into process rays of the hand, which allows obtaining good cosmetic and functional results in these patients.