Purpose
Toe phalanx transplantation is a well-established technique for addressing bony deficiency
in the reconstruction of hypoplastic digits in patients with congenital differences
of the hand. Prior studies have commented on varying degrees of donor-site morbidity,
although assessment of morbidity with validated outcome scores is lacking. This study
seeks to evaluate donor-site morbidity after toe phalanx harvest using validated outcome
measures.
Methods
We identified all children who underwent free, nonvascularized toe phalanx transfer
to the hand at our institution from 2001 to 2011. We administered the Oxford Ankle
Foot Questionnaire for Children (OXAFQ-C) and the Foot and Ankle Ability Measure (FAAM)
to all patients, scaling results according to published scoring instructions.
Results
Thirty-six patients with 83 toe phalanx transfers were able to be contacted, with
a mean follow-up of 5.3 years (range, 18 months–11.2 years). The results of the OXAFQ-C
showed mean scores of 99.96% (Physical), 100% (School and Play), and 96.01% (Emotional).
The FAAM mean scores were 99.08% (Sports) and 99.17% (Activities of Daily Living).
There were no lower extremity complications during the study period.
Conclusions
In contrast to varying degrees of donor-site morbidity reported in the current literature,
this study demonstrates that toe phalanx harvest causes almost no measurable lower
extremity morbidity or dysfunction over the mid- to long-term.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: July 11, 2019
Accepted:
April 9,
2019
Received:
November 15,
2018
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
