Non-vascularized toe phalanges transplantation in congenital hand malformations

Abstract

According to the world literature, congenital malformations of the upper limb are found in 2.37.9 per 10 thousand live births, while anomalies in the development of the hand occur in 6595% of patients, the most common are reduction anomalies (brachydactyly, ectrodactyly, adactyly, hypoplasia). Various methods of reconstructive plastic surgery are known in the world literature, including microsurgery, compression-distraction osteosynthesis, various types of skin, tendon-muscle and bone plasty, as well as prosthetics. Non-vascularized toe phalanges transplantation is a less common method, which is effective and technically accessible in case of reduction anomalies of the hand. This study is aimed at studying the relevance of the application of the presented method based on the analysis of world literature. The aim of the review is the analysis of the world experience of using non-vascularized toe phalanges transplantation in case of congenital hand malformations. A search was made for literature sources in the open electronic databases PubMed and eLibrary for the last 110 years. The publications devoted to the study of the effectiveness of transplanting the phalanges of the toes into defects of the fingers in clinical practice are analyzed. This method has a number of advantages: low morbidity for the donor foot, minimal risk of resorption of the transplanted graft, restoration of the anatomy of the formed finger, preservation of blood supply and sensitivity in the formed finger, the possibility of phalanx growth while maintaining the growth zone, the functionality of the fingers. At the same time, such issues as the detailed functioning of the growth zone of the non-perfusion phalanx after its transplantation, the reasons for the continuation or cessation of growth in the short term after surgery, the resorption of displaced phalanges, and the dependence of the mobility of the reconstructed fingers on the technology of interventions are not indicated anywhere. Conducting further research on the role of transplantation of non-vascularized toe phalanges in the pathology of the hand in children seems to be an actual task.