Immediate Non-thumb Digit Transposition After Hand Trauma: Historical Perspective and Case Report

Abstract

Mutilating hand trauma remains a challenge for reconstructive hand surgeons, owing to the involvement of multiple tissue types and segmental nature of these injuries. Principles of “spare parts” surgery may be useful in assessing how to make use of otherwise unsalvageable or functionless tissue. Pedicled heterotopic digit transposition is such a procedure; it may be safely performed in the acute posttraumatic setting. The historical basis for digit transposition and related techniques are reviewed. Two illustrative cases in which a single functional finger was created from 2 severely traumatized digits are presented. This reconstructive technique should be considered when a patent vascular pedicle, appropriate length, and intact articular surfaces are present in the donor digit. Digit transposition is a useful addition to the hand surgeon’s techniques for restoring posttraumatic hand function after mutilating injury. Key words: amputation, digit, hand trauma, reconstruction, replantation