A New Dynamic External Fixation Method in Finger Replantations and Toe-To-Hand Transfers

Abstract

Objective:This study presents a simple and versatile finger fixation method facilitating rehabilitation in the early period and better functional results in replantation and toe-to-hand transfer patients.Methods:In 12 patients, bone fixations were performed by using a dynamic external finger fixator system. The duration of fixations was recorded. The potential complications, such as non-union, pain, joint stiffness, infection of pins, inadequate stabilization, and swelling, were documented. Subjective pain scale was applied on each patient, and the level of satisfaction of patients was examined.Results:All finger transfers and replantations were achieved. The mean time of bone fixation was 11.6 minutes (9 to 20 min.). Nonunion associated with fixation and infection did not occur. Whereas 8 patients were satisfied with the functional results, 3 replantation cases and 1 toe-to-hand transfer patient were dissatisfied. In the assessment of the appearance of the finger, 2 replantation cases and 4 toe-to-hand transfer patients (50% of all cases) were dissatisfied.Conclusion:We are convinced that this dynamic external fixation system, including versatile advantages, such as arranging earlier finger motion, having a simple and quick learning process, reducing the operation time, being able to be used as contributing material in anastomosis, and having fewer complications, can be successfully used in replantations and toe-to-hand transfers.

Keywords

• Toe-to-hand transfer
• replantation
• dynamic external fixator
• ligamentotaxis