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At least 973 records · Page 54Linked to original sources
PubMed1998

Thumb reconstruction by pollicization of an index finger stump combined with a wrap-around flap from the big toe.

A finger stump pollicization combined with a thin wrap-around procedure from the big toe for reconstruction of the thumb is described. This technique permits excellent functional and cosmetic restoration, providing length to the new thumb as well as widening the first web. There is joint motion in the reconstructed thumb. Sensibility of the transferred pulp is good and allows fine pinch without pulp shrinkage. This method is indicated in cases of multidigit amputations, for thumb loss near the carpometacarpal joint.

Adult↗
PubMed2002

Epidural spinal cord stimulation for the treatment of painful legs and moving toes syndrome.

A case of 51-year-old male with painful legs and moving toes syndrome was successfully treated with epidural spinal cord stimulation. He was previously treated with varieties of medication, epidural block, transcutaneous nerve stimulation, lumbar sympathetic block, with no or only a transient effect. Epidural spinal cord stimulation was applied by means of percutaneously inserted epidural electrodes connected to a percutaneous extension for 2-week test stimulation period and later to a permanent device (ITREL). Pain and involuntary movement were relieved almost completely during the stimulation and the effect was still evident 6 months later.

Electric Stimulation Therapy↗
PubMed1999

An 'annoying' foot: unilateral painful legs and moving toes syndrome.

The syndrome of painful legs and moving toes is an uncommon condition causing distressing leg pain and is recognised chiefly by the characteristic involuntary movements. This case report describes an unusual unilateral clinical presentation, which led to a delay in diagnosis.

Aged↗
PubMed1996

Distally based dorsalis pedis island flap for a distal lateral electric burn of the big toe.

Reconstruction of the small defects in the distal portion of the foot has always represented a difficult problem. A case of a young man with a deep electric burn of the distal lateral side of the big toe successfully treated with a distally based dorsalis pedis island flap based on the first dorsal metatarsal artery (FDMA) is presented. The donor site area of the dorsum of the foot was grafted, and deambulation was reassumed 3 weeks later. Advantages; limits and anatomical consideration regarding the viability of the flap are also discussed.

Adult↗
PubMed1991

Vascularized single toe joint transfer to the hand.

We report a retrospective review of our series of thirty-one single joints harvested from the toe in twenty-six patients and transferred to the metacarpophalangeal or proximal interphalangeal joint of the finger. Twenty-six transfers were done in traumatic cases and five in congenital. Follow-up averaged 22.6 months. Average range of motion was from 17.1 degrees to 44.3 degrees, with an arc of 27.2 degrees. The congenital group had an average motion ranging from 14.4 degrees to 27.2 degrees and an arc of 12.8 degrees. The traumatic group's motion was from 17.6 degrees to 47.6 degrees and an arc of 30.0 degrees. Complication rates were significant, with fifty percent of the patients experiencing one or more complications. Although vascularized joint transfer is a demanding procedure, it provides a reasonable alternative to arthrodesis and with further refinement in technique may become a reliable treatment option.

Adolescent↗
PubMed1980

Thumb reconstruction with a free neurovascular wrap-around flap from the big toe.

Thumb reconstruction requires accurate functional and esthetic approximation to the original. Accepted methods generally have some deficiencies, particularly in appearance, and frequently the secondary morbidity is unacceptable. A method of thumb reconstruction with the use of an iliac crest bone graft and a free neurovascular "wrap-around" flap from the big toe is described that combines the attributes of previous methods without their secondary morbidity.

Adult↗
PubMed1980

Simultaneous transfer of the right and left second toes for reconstruction of amputated index and middle fingers in the same hand--Case report.

Simultaneous transfer of the second toes of the right and left feet was done to reconstruct the index and middle fingers in a 23-year-old man. A two-team microsurgical procedure approach was used. Technical aspects of the procedure are described. Long-term functional results have been good, both cosmetic and functional. Only one previous case of this type was described by Ohtsuka in 1977.

Adult↗
PubMed1982

Composite toe (phalanx and epiphysis) transfers in the reconstruction of the aphalangic hand.

Twenty children with ectrodactyly have had 36 digits reconstructed with toe phalanges inserted into the existing soft tissue finger pouches or pouches constructed with local tissue. Care is taken to preserve the periosteum, epiphyseal plate, and collateral ligaments of the transfers. No surgical microvascular anastomoses are performed, and the entire procedure takes less than 30 minutes. Epiphyseal patency rates in children with a mean follow-up of 3.4 years and a median of 4 years are 90% for those operated on at 6 months to 1 1/2 years of age, 67% in those operated on at 1 1/2 to 5 years, and 50% in children operated on at 5 to 13 years of age. Radiographic growth measurements show average growths greater than 90% of the expected growth based on measurements of the contralateral donor phalanx for all transfers with open epiphyses. These reconstructed digits provide fingers that are sensate, capable of pinch and grasp, and able to tolerate heavy use.

Adolescent↗
PubMed1983

A free total toe phalanx transplant to a finger: a case report.

A six-year-old boy sustained traumatic loss of the index finger middle phalanx of his right hand and one year after the accident the proximal phalanx of the fourth toe was transplanted to the index finger as a free graft. Four years after the operation x-ray films demonstrate acceptance of the graft and satisfactory function of the finger.

Amputation, Traumatic↗
PubMed1984

Free microvascular transfer of second toe ray and serratus anterior muscle for management of thumb loss at the carpometacarpal joint level.

A 50-year-old machine operator suffered traumatic amputation of the thumb, ring, and small fingers. The thumb had been amputated at the carpometacarpal joint and was reconstructed 6 months later by microneurovascular transplantation of the second toe including the second metatarsal. Opposition was provided and the first web space was released at a second stage by reconstruction with the lowest two digitations of the serratus anterior muscle covered with a split-thickness skin graft.

Amputation, Traumatic↗
PubMed1986

Reconstruction of a hand, amputated at the metacarpophalangeal level, by means of combined second and third toes from each foot: a case report.

Reconstruction of all four fingers that were amputated at the metacarpophalangeal (MP) joints of the right hand of a 17-year-old male patient was performed by simultaneous transfer of the combined second and third toes from each foot at the level of the metatarsophalangeal joint. Fifteen-month follow-up showed acceptable cosmesis with satisfactory functional results. The patient had no foot discomfort, even after prolonged walking and running.

Adolescent↗
PubMed1987

Toe transfer to the vessels of the reversed forearm flap.

A 23-year-old man had a severe degloving injury of his hand, amputation of multiple fingers, and devascularization of the thumb. Primary care consisted of successful revascularization of the thumb and skin grafting of the hand. Secondary soft tissue reconstruction of the hand was done with a reverse forearm flap. This was followed by second-toe transfer to the hand, with the recipient vessels, the radial artery, and the venae comitantes of the reverse forearm flap.

Adult↗
PubMed2003

Evaluation of toe pressure and transcutaneous oxygen measurements in management of chronic critical leg ischemia: a diagnostic randomized clinical trial.

OBJECTIVE: The definition of critical limb ischemia (CLI) requiring vascular intervention is still under debate. The clinical eye of the physician and ankle blood pressure measurements used so far may fall short in appreciation of the severity of disease, which makes decision-making for a vascular intervention subjective. In previous studies two simple functional tests, ie, transcutaneous oxygen pressure (tcPo(2)) and toe blood pressure (TP) measurements, provided reliable information about the need for vascular intervention. Therefore we evaluated the diagnostic value of tcPo(2) and TP in management of clinically suspected critical leg ischemia. Study design This was a diagnostic randomized controlled clinical trial. Subjects were ambulatory and hospitalized patients in a referral university hospital. METHODS: Ninety-six patients (128 legs) with clinically suspected critical limb ischemia were referred to the vascular laboratory for routine investigation. Two diagnostic management strategies were compared: conventional strategy, ie, clinical judgment and ankle pressure determined the diagnostic and therapeutic approach, and a new strategy in which tcPo(2) and TP determined the diagnostic and therapeutic approach. Main outcome measures included clinical outcome, defined as pain relief, wound healing, and limb survival. RESULTS: At 18-month follow-up, 26 of 62 legs treated with the conventional approach and 28 of 66 legs treated with the new approach were treated conservatively. The new method did not score significantly different from the conventional method insofar as clinical outcome: pain score, 50 versus 48; number of amputations, 8 versus 10; and number of deaths, 11 versus 8 deaths, respectively. CONCLUSION: Two simple objective diagnostic tests, TP and tcPo(2), did not improve clinical outcome when incorporated into routine management of suspected critical limb ischemia. Nevertheless, these techniques might still be helpful for physicians less experienced with treating critical limb ischemia and who are in doubt regarding the need for vascular intervention.

Aged↗
PubMed1999

Arthroscopic medial bipartite sesamoidectomy of the great toe.

This is the first report of a successful first metatarsophalangeal joint medial bipartite sesamoidectomy using great toe arthroscopy. The surgical trauma associated with open operative sesamoidectomy can be minimized using minimally invasive techniques under arthroscopic control. The authors describe the surgical principles and discuss the advantages compared with traditional surgery.

Adult↗
PubMed1994

[A free transfer of the pulp of the toe with an exteriorized flap. A compromise between microsurgery and traditional surgery].

Free toe pulp transfer represents the most sophisticated technique which corresponds functionally as close as possible to total restoration of the digital pulp. However, this operation presents technical disadvantages related to the very small calibre of the vessels when the vascular anastomosis is performed in the digit. When the artery and vein are anastomosed in the metacarpal region to achieve vessels with a larger calibre, the passage of the pedicle in the finger is difficult and requires complete opening of the digital canal, resulting in a finger which is often enlarged with limited mobility. The authors propose a technique which overcomes these two disadvantages.

Anastomosis, Surgical↗
PubMed1992

Multiple microsurgical toe-to-hand transfer in the reconstruction of the severely mutilated hand. A series of fifty-nine cases.

The severely mutilated hand is defined as the hand which has lost opposable digit function either through: a) The amputation of all four fingers proximal to the PIP joint or b) The loss of the thumb proximal to the IP joint combined with the loss of at least three fingers proximal to the PIP joint. We have outlined guidelines for the restoration of useful function and appearance to such hands utilising a variety of microsurgical toe-to-hand transfers. Specific points regarding postoperative management have been made.

Adolescent↗
PubMedDate not supplied

Varus toes: a review and case report.

The authors present an overview of varus or curly toe deformity. This congenital deformity can be seen in many generations of the same family, with no greater incidence in males or females. The hereditary influences on the inheritance of this deformity have not been clearly defined but appear to follow an x-linked or autosomal dominant pattern. The deformity is very often dismissed by physicians, and if left untreated can lead to more serious digital pathology later in life.

Child, Preschool↗