Document Detail


Replantation of the great toe: review of 20 cases.
MedLine Citation:
PMID:  18766044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although great toe loss represents not only disruption of external body integrity but also a functional defect with possible psychological consequences, only a few publications concerning great toe replantation have been reported in the literature. The purpose of this study was to present the authors' experience with great toe replantation.
METHODS: The authors retrospectively reviewed 20 cases in which replantation or revascularization of the great toe was attempted. Clinical factors, such as the patient's age at the time of surgery, injury level, mechanism, amputation type, associated injury, and intraoperative or postoperative complications were recorded. A Fisher's exact test was used to determine which clinical factor revealed statistical differences for the survival of replanted toes.
RESULTS: The overall survival rate was 55 percent. The main cause of failure was arterial insufficiency, and vasospasm played the leading role. Although the subgroups containing children, incomplete amputation, and no involvement of the lateral toes showed better survival rates, the difference was not statistically significant. When complete amputation of great toes was associated with injuries of the lateral toes, the survival rate was significantly decreased compared with the other cases (p < 0.05).
CONCLUSIONS: The goal of great toe replantation is to preserve the integrity of the metatarsophalangeal joint. The authors emphasize that great toe replantation should be restricted to traumatic amputations in children and incomplete amputations in adults, especially at the level proximal to the interphalangeal joint. Complete amputation of the great toe with injuries of the lateral toes is a poor prognostic factor for the survival of replanted toes.
Authors:
Cheng-Hung Lin; Chih-Hung Lin; Paolo Sassu; Chung-Chen Hsu; Yu-Te Lin; Fu-Chan Wei
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  122     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-03     Completed Date:  2008-09-19     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  806-12     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Amputation, Traumatic
Child
Child, Preschool
Female
Humans
Infant
Intraoperative Complications
Male
Middle Aged
Postoperative Complications
Prognosis
Replantation*
Retrospective Studies
Toes / blood supply,  injuries,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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