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At least 469 records · Page 26Linked to original sources
PubMed1984

Congenital familial hypoplastic thumb associated with congenital amputation of the toe.

A family with congenital hypoplastic thumb ( Blouth type 1) associated with congenital amputation of the first toe is reported. An 18-year-old woman and her mother had the same congenital anomalies: hypoplastic thenar muscles, congenital amputation of the first toe, slight web formation between second and third toes, and brachymesophalangia 2 and 5. There were no associated cardiovascular defects. They have a characteristic metacarpophalangeal pattern profile. This is believed to be the first such case report in the medical literature.

Adolescent↗
PubMed1988

Great toe-to-hand transfer: role of the preoperative lateral arteriogram of foot.

This report correlates the results of the lateral angiogram of the foot with the operative dissection and eventual outcome in 29 patients in whom a great toe-to-hand transfer was performed to treat a traumatic loss of the thumb. Our angiographic findings were confirmed by surgical exploration and indicated that (1) in 20 (70%) of 29 patients the first dorsal metatarsal artery (FDMA) originated from the dorsalis pedis artery, dorsal to the midlongitudinal axis of the first metatarsal bone; (2) in 6 (20%) of 29 patients the FDMA originated from the dorsalis pedis artery, plantar to the midlongitudinal axis of the first metatarsal bone; (3) in the remaining 3 (10%) of 29 patients the arteriogram of the lateral foot indicated that the plantar metatarsal artery supplied the great toe in a dominant pattern, necessitating its use as the donor vessel; and (4) the measured lumenal diameters of the dorsal and plantar metatarsal arteries (mean diameter = 1.30 mm and 1.27 mm, respectively) did not significantly differ. The lateral views of the foot were helpful in permitting distinct identification of the location and size of the metatarsal arteries to the great toe.

Amputation, Traumatic↗
PubMed1997

Resurfacing of the donor defect after wrap-around toe transfer with a free lateral forearm flap.

In thumb reconstruction, the wrap-around free flap has many advantages; however, delayed wound healing, pain, and skin ulcerations at the donor site can be a problem. In 5 patients, a free lateral forearm fasciocutaneous flap was successfully used for immediate resurfacing of the donor defect of the big toe during wrap-around procedures. This flap was selected after preliminary anatomic studies that showed that it could be safely raised if based on the anterior terminal division of the posterior radial collateral artery. The average follow-up period was 2 years. The time required for healing of the great-toe defect was less than 1 month. All patients were satisfied with the outcome of the procedure. The skin of this flap is very pliable and thin, and the subcutaneous tissue is about half the thickness of that of the lateral arm flap. This technique is especially indicated for closure of moderate to big skin defects at the great-toe level, whenever a larger than usual amount of skin is required, during wrap-around procedures for thumb reconstruction.

Adolescent↗
PubMed1998

Microarterial anatomy of the lesser toe proximal interphalangeal joints.

Successful free tissue transfer requires detailed knowledge of the pertinent microvascular anatomy of the donor site. The lesser toe proximal interphalangeal joints are a source of vascularized autologous tissue. In 20 adult cadaver feet, the arterial anatomy of the second, third, and fourth toes was studied using colored latex and India ink injection. The second, third, and fourth dorsal metatarsal arteries produced small or absent dorsal digital arteries in 72.5% of distal dissections. The proper digital arteries were 0.93 to 1.37 cm in length. An additional 2.3 to 2.83 cm of length can be gained by use of the plantar metatarsal arteries if the dorsal metatarsal or dorsal digital arteries are inadequate. The diameter of the medial proper digital arteries (range, 1.2-1.26 mm) was larger than the lateral proper digital arteries (range, 0.66-0.99 mm). The proper digital arteries of the lesser toes provide the predominant arterial supply of the proximal interphalangeal joints through a system of transverse and longitudinal arches.

Adult↗
PubMed1994

[Reconstruction of the long fingers using toe transfers].

The authors review 29 toes transfers on 24 patients with injury of long fingers between 1985 and 1990. The series contains 16 complete toes and 13 partial toes transfers. The results, inconvenience and indications are discussed.

Adolescent↗
PubMedDate not supplied

Transesophageal echocardiographic findings in blue toe syndrome exacerbated by anticoagulation.

The role of anticoagulation in the blue toe syndrome is unresolved. We describe the sonographic appearance of atherosclerotic plaques in the thoracic aorta imaged by transesophageal echocardiography in 2 patients with blue toe syndrome who had reembolization while taking therapeutic levels of anticoagulants. The findings of complex atheromas associated with mobile highly echodense linear structures by transesophageal echocardiography may be predictive of reembolization in patients with blue toe syndrome who are taking anticoagulants.

Aged↗
PubMedDate not supplied

Massive fibrolipoma of a toe.

Soft-tissue tumors of the toes are not particularly common; more tumors of the toes arise from the skin. The deeper tumors can be either benign or malignant and must be treated with caution until a histologic diagnosis has been made. However, malignant soft-tissue tumors of the toes are fairly rare. An unusual case of a massive benign lipoma was treated by an excisional biopsy (disarticulation).

Foot Diseases↗
PubMed2000

The donor foot in free toe or joint transfers.

Eighty-four cases of free second toe, multiple toe or second metatarsophalangeal joint transfers were studied by case review and follow-up. The function of the donor foot had recovered completely within 6 months in 89% of patients. The wounds on the donor foot healed in 2-3 weeks in 90% of patients. Slight numbness on the dorsal aspect of the donor foot, intolerance to cold, mild reduction in push-off, scar tenderness and pain or swelling occurred in only a few patients and generally were not considered of significance. Multiple toe transfers created more donor problems in terms of healing and appearance. Some foot deformities with plantar callosities were observed at long term review. However, all patients were capable of work and normal activities.

Adult↗
PubMed2002

Microvascular toe transfer for cleft-foot plasty: eight-year follow-up.

No exact equivalent procedure has been developed for cleft-foot plasty. In the case of a four-year-old boy, the plasty was achieved by using microvascular toe transfer from a contralateral side that was amputated. Eight years postoperatively, the longitudinal growth of the grafted toe is symmetric, compared to the recipient toes, and the appearance of the treated foot is quite natural. The patient can run with a prosthesis on the amputated leg. It is suggested that utilization of parts from a useless extremity is important to reconstruct the other extremity.

Amputation, Surgical↗
PubMed2002

[Therapy of the peromelic form of symbrachydactyly by double second-toe transplantation].

From 1989 to 2001 eleven children with the peromelic type of symbrachydactyly underwent a staged double second toes transplantation for restoration of two finger rays. The second toe of the feet were transplanted first to the small finger position and in the second step to the thumb position. One failure occurred in the first toe transplantation and another developed a venous thrombosis with partial necrosis and eventually a useless ray. Eight children were reviewed retrospectively in a mean follow-up of 5.3 years. The ability to pinch was restored in four children. In all patients without complications the function of the hand improved and the sensitivity was good.

Adolescent↗
PubMed2004

Primary reconstruction of a degloved hand using multiple toe transfers on a single pedicle and a reversed radial artery flap.

This case study reports one-stage reconstructive surgery on an 18-year-old man who was injured by an industrial roller machine and who presented with a degloved hand. Non-replantable delgloving occurred in all fingers, with the loss of the palmar and part of the dorsal skin. Multiple free contiguous toes were transferred based on a single dorsalis pedis artery pedicle. The artery was anastomosed to a reversed radial artery flap, which was used to cover the palm for primary reconstruction of the degloved hand. Multiple toes were harvested from the same foot, based on a single pedicle, to contain the potential morbidity to one foot, to enable primary reconstruction, and to decrease the length of the operation. The flaps healed well, and the patient demonstrated adequate tripod pinch and key pinch with the transferred toes, with a two-point discrimination of 12 mm at 1-year follow-up. The patient was satisfied with both the appearance and function of the hand and foot.

Accidents, Occupational↗
PubMed2005

Coverage of big toe defects after wrap-around flap transfer with a free soleus perforator flap.

In thumb reconstruction, a wrap-around flap transfer from the big toe gives excellent results aesthetically and functionally; however, there may be some problems at the donor site, such as delayed wound healing and skin ulceration. In 10 patients, a free soleus perforator flap was used for immediate coverage of defects of the big toe with wrap-around flap procedures. Eight flaps survived completely, and the time required for wound healing was less than 1 month. Two flaps developed partial necrosis and required additional skin grafts. The average follow-up period was 46 months. There were no patients requiring defatting of the flaps. There were no patient complaints, such as postoperative skin erosion or ulceration. All patients were satisfied with the outcome. A free soleus perforator flap is an available method for covering defects of the big toe after wrap-around flap transfer.

Adolescent↗
PubMed2006

Two cases of big-toe replantation: a ten-year follow-up.

It is rare for traumatic amputation of the big toe to occur as a single injury. This trauma is especially significant in children for influencing foot development and for possible psychological impact. Two cases of successful replantation of completely amputated big toes in two girls, 2 years 7 months and 5 years 2 months old, are presented. Follow-up was 10 years. In the younger child, the replanted big toe was 49.2 percent shorter compared to the contralateral side, because growth was limited by the affected growth zone in the proximal phalanx. In the older child, the growth zone of the bone was intact, with consequent bone growth unimpaired, and an initial shortage of 10.4 percent was reduced to 2 percent compared to the contralateral side.

Amputation, Traumatic↗
PubMed1998

Flow-through vascularized toe-joint transfer for reconstruction of segmental loss of an amputated finger.

A segmental finger defect was reconstructed in a 46-year-old woman with a free flow-through vascularized toe-joint, including the proximal interphalangeal joint, the plantar digital nerve, and tendons of the second toe. The advantages of this composite flap are: (1) The segmental loss of the finger can be easily reconstructed to achieve a normal anatomic structure. (2) Excellent cosmesis is achieved, compared with conventional flaps such as the groin flap. (3) The distal segment of the donor toe can be preserved. (4) The transected digital arteries of the amputated finger can be simultaneously reconstructed with a flow-through arterial interposition. (5) The digital nerve can be repaired with a vascularized plantar digital nerve graft.

Female↗
PubMed1991

Closure of big toe defects after wrap-around flap transfer using the arterialized venous flap.

Sixteen arterialized venous flaps, free flaps that have arterial blood only flowing through the vein of the flap, were applied to reconstruct skin defects of the big toe resulting from wrap-around flap transfers. There were seven complete successes, six partial successes, and three complete failures. The clinical course of the cases indicated that the donor site itself and flap tension due to postoperative edema might play key roles in flap survival. The success rates of the flap from the leg and foot donor sites (including partial survival cases) were 75 percent and 87.5 percent, respectively. Flaps from the leg donor site appeared to develop more extensive postoperative congestion and edema than those from the foot donor site, which had a negative effect on flap survival. Covering the big toe with this flap causes no significant morbidity. The technique may have potential indications for closing a big-toe defect after a wrap-around flap transfer.

Adolescent↗
PubMed1988

The dorsal approach in harvesting the second toe.

The dorsal approach, with early section of the second metatarsal bone, allows direct access to the plantar structures of the second toe (arteries, nerves, and flexor tendons). A "multiple set arterial transfer" then becomes possible, improving the blood supply to the toe. Early walking is encouraged on the fifth postoperative day when the patient leaves the hospital. No vascular complications have occurred in any microvascular reconstruction after the fifth postoperative day. Close approximation of the first and third toe of the donor foot not only improves the overall appearance of the foot, but also avoids a possible hallux valgus deformity as a postoperative complication.

Anastomosis, Surgical↗
PubMed1986

Sensory recovery in replanted digits and transplanted toes: a review.

A review of replanted digits has indicated that excellent sensory function can be recovered in replants that are distal, in which the mechanism of injury has been a sharp cut, in which the patient's age is young, and in cases where the patient receives postoperative sensory re-education. It appears that poor sensory recovery in replanted digits is most directly attributable to crush or avulsion type injuries and lack of sensory re-education in the postoperative period. The level of sensory recovery in toe-to-thumb transfers appears to be better than in the donor toe and better than in replanted digits. The explanation for this most likely lies in the sharp "mechanism of injury" in the toe-to-thumb transfer and in the "extra" postoperative rehabilitation such cases receive. Future improvements in recovery of sensation in replanted digits may come from increased use of nerve grafting in those digits that have been crushed or avulsed, and by instituting routine sensory re-education in the postoperative period.

Adult↗
PubMed2001

Subungual exostosis of the third toe.

Subungual exostosis is a variant of osteochondroma that appears as a pinkish nodule under the free end of the nail plate. It becomes symptomatic when large enough to disrupt the overlying nail on the digit or through mechanical irritation of the exostosis from physical activity. Appropriate workup of such a lesion is important, because many cases of subungual exostosis are initially misdiagnosed by a variety of specialists, including dermatologists. With the use of history and roentgenography, subungual exostosis can be effectively diagnosed or excluded. Appropriate treatment of subungual exostosis can be selected- surgical excision of the lesion with significant cure rates achieved. Although most cases of subungual exostosis are localized to the great toe, we describe a 32-year-old woman who developed a subungual exostosis on her right third toe. Appropriate diagnostic workup and surgical treatment of the right third-toe exostosis has resulted in complete relief of symptoms with no signs of recurrence 7 months after surgery.

Adult↗