Microvascular Partial Toe Transfer

NCT ID: NCT04192084

Last Updated: 2019-12-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-01

Study Completion Date

2020-12-01

Brief Summary

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Microvascular partial toe transfer for reconstruction of traumatic amputation of the digits

Detailed Description

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Microsurgical toe transfer has become a gold standard option for amputated digit reconstruction. It can be used to correct almost any thumb defect. However, for optimal functional and esthetic results, proper initial care, preoperative planning, proper selection of suitable techniques, adjunct or secondary procedures and proper, postoperative rehabilitation are important.

The transfer of a toe to replace an amputated thumb represents one of the first applications of microsurgical techniques, yet to this day remains an epitome of reconstructive surgery, restoring critical function and form to the hand-injured patient. While techniques have greatly evolved to permit the treatment of multiple finger amputations, dystrophic nails and pulps, and traumatized or arthritic joint, the amputated thumb retains its status among the most indubitable indications for toe transfer. Microsurgical techniques have been refined to such a degree that almost any ablative deformity of the thumb could be corrected with some form of toe transfer. The question, therefore, is not if a defect could be reconstructed, but whether the patient is willing to undergo reconstruction. The concepts of "adequate function" and "optimal function" are therefore of central importance when discussing treatment options with a patient. Obviously, these parameters will be different for each patient depending upon his/her vocation, avocations, and desires. For many people, adequate function might be expected with an amputation that retains some length of the proximal phalanx (assuming sufficient soft tissue coverage is present or can be provided). However, for patients who require full length of their thumb, or who desire optimal rather than adequate function, toe transfer should be considered.

At present, the decision to use a particular toe transfer technique is mostly based on the surgeon's preference and training. The current data are inadequate to make any comments with regards to donor site morbidity. Till such data are available, an evidence-based recommendation for the superiority of a specific type of toe-to-thumb transfer cannot be made. We hypothesis that partial toe transfer provides the best aesthetic and functional reconstruction and the least donor site morbidity amongst all other types of transfers.

Conditions

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Amputation, Traumatic Hand Injuries

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Traumatic amputations of the digits

we will perform microvascular partial toe transfer for patients with traumatic amputations of one or more digits

Group Type EXPERIMENTAL

microvascular partial toe transfer

Intervention Type PROCEDURE

we will perform microvascular partial toe transfer for patients with traumatic amputation of one or more digits

Interventions

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microvascular partial toe transfer

we will perform microvascular partial toe transfer for patients with traumatic amputation of one or more digits

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient from 18-50 years old
* one or more finger amputations
* Minimum follow-up period of 6 months

Exclusion Criteria

* patients whose loss was due to congenital anomaly.
* Patients who did not have a minimum follow-up period of six months .
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Yousif Tarek El-Gammal

assistant lecturer

Responsibility Role PRINCIPAL_INVESTIGATOR

References

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Reference Type BACKGROUND
PMID: 4959061 (View on PubMed)

Cobbett JR. Free digital transfer. Report of a case of transfer of a great toe to replace an amputated thumb. J Bone Joint Surg Br. 1969 Nov;51(4):677-9. No abstract available.

Reference Type BACKGROUND
PMID: 5371970 (View on PubMed)

Wei FC, Chen HC, Chuang CC, Noordhoff MS. Simultaneous multiple toe transfers in hand reconstruction. Plast Reconstr Surg. 1988 Mar;81(3):366-77. doi: 10.1097/00006534-198803000-00009.

Reference Type BACKGROUND
PMID: 3340671 (View on PubMed)

Wei FC, Lutz BS, Cheng SL, Chuang DC. Reconstruction of bilateral metacarpal hands with multiple-toe transplantations. Plast Reconstr Surg. 1999 Nov;104(6):1698-704. doi: 10.1097/00006534-199911000-00013.

Reference Type BACKGROUND
PMID: 10541171 (View on PubMed)

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Reference Type BACKGROUND
PMID: 3351225 (View on PubMed)

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Reference Type BACKGROUND
PMID: 4052709 (View on PubMed)

Wei FC, Chen HC, Chuang DC, Chen S, Noordhoff MS. Second toe wrap-around flap. Plast Reconstr Surg. 1991 Nov;88(5):837-43. doi: 10.1097/00006534-199111000-00016.

Reference Type BACKGROUND
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Chen SH, Wei FC, Chen HC, Hentz VR, Chuang DC, Yeh MC. Vascularized toe joint transfer to the hand. Plast Reconstr Surg. 1996 Dec;98(7):1275-84. doi: 10.1097/00006534-199612000-00025.

Reference Type BACKGROUND
PMID: 8942916 (View on PubMed)

Lutz BS, Wei FC. Basic principles on toe-to-hand transplantation. Chang Gung Med J. 2002 Sep;25(9):568-76.

Reference Type BACKGROUND
PMID: 12479617 (View on PubMed)

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Reference Type BACKGROUND
PMID: 22942845 (View on PubMed)

Wei FC. Tissue preservation in hand injury: the first step to toe-to-hand transplantation. Plast Reconstr Surg. 1998 Dec;102(7):2497-501. doi: 10.1097/00006534-199812000-00039.

Reference Type BACKGROUND
PMID: 9858192 (View on PubMed)

Yim KK, Wei FC. Intraosseous wiring in toe-to-hand transplantation. Ann Plast Surg. 1995 Jul;35(1):66-9. doi: 10.1097/00000637-199507000-00013.

Reference Type BACKGROUND
PMID: 7574290 (View on PubMed)

Wilson CS, Buncke HJ, Alpert BS, Gordon L. Composite metacarpophalangeal joint reconstruction in great toe-to-hand free tissue transfers. J Hand Surg Am. 1984 Sep;9(5):645-9. doi: 10.1016/s0363-5023(84)80004-0.

Reference Type BACKGROUND
PMID: 6386954 (View on PubMed)

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Reference Type BACKGROUND
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Reference Type BACKGROUND
PMID: 8700986 (View on PubMed)

Other Identifiers

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Toe Transfer

Identifier Type: -

Identifier Source: org_study_id