Second Toe Transfer for Thumb Reconstruction in a 4 year old child
Microsurgeons get the toe to do a "Thumbs up"
The thumb of 4 year old Manjula was crushed accidentally when it got caught in the wheel of a two wheeler. It was reconstructed using her own second toe with the help of microsurgery. The amputation was through the epiphyseal plate (growing end) of the proximal phalanx . The part was not fit for replantation. Hence the amputation stump was closed with the available skin.
|Reconstruction of an amputated thumb in a small child is a challenge since options like Osteoplastic technique and micro surgical techniques like wrap around do not have growth capability. That leaves only toe transfer as the option. The parents of the child were explained about the options of reconstruction of the thumb. They did not agree for removing tissues from the great toe. They opted for second toe transfer as it had a better cosmetic donor defect. Three weeks after injury, she was readmitted for toe transfer.||
surgery lasted six hours and at the conclusion of the surgery the TOE-TURNED-THUMB
assumed a healthy pink colour signifying the success of the operation.
This new thumb will have sensation, movement and nail growth.
She can now look forward to going back to school and have a normal
of this surgery can be appreciated if one imagines a hand without the thumb.
The Loss of thumb is very disabling. Though the disability of the
loss of thumb is rated as 40% for calculation of compensation purposes,
its real significance can be felt while doing some of the daily activities
like holding a cup, writing, putting on a shirt button, eating food, etc.,
The only action you can do is push the wall or lift a bag!
Dr. S. Raja
Dr. V. Ravindra