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Digital Transfer in Congenital Hand Malformation

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ABSTRACT

Morphofunctional rehabilitation of the congenital hand with absent fingers or deficiencies involves early reconstruction of the digital pinch using tissues similar in function and aspect. Toe transfer represents the best method. This review consists of eight patients operated on in the past 2 years with absence or malformation of one digital ray (n=3) and two to five digital ray malformation (n=5). Patient age ranged from 8-22 years and patients were predominately female (n=6).

Our method consisted of free digital transfer of the great toe (n=1), entire (n=3) and partial (n=1) second toe, and digital block of the second and third toes (n=3). The evolution was favorable in all cases. The mobility was evaluated from M2 to M4 and the sensibility from S2 to S3 at 1-year postoperatively.

Digital transfer represents the best therapeutic option in our opinion. The intervention must be performed as early as possible considering the better cortical integration in young patients. Although the method is technically difficult, the results are better with earlier recovery and shorter hospitalization.