Ganga Medical Centre & Hospitals Pvt Ltd

Coimbatore, India.

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Short and Absent Fingers

Symbrachydactyly

Free Phalangeal Bone Transfer

Sometimes children are born with shorter or absent fingers. In some children there will be some soft tissue in the stump with no bone. Such children need creation of new fingers or lengthening of the existing fingers.

To provide stability to the existing extra soft tissue in the position of fingers, we can introduce bone into the soft tissue sleeve. Usually one of the phalanges from the toes is taken and placed inside the finger. Since it is not taken with its blood vessels it is called a Free Phalangeal bone transfer. They in many instances significantly improve the functional status of the hand.

Microsurgical transfer of a toe usually yields better results. When many fingers are involved or when parents are not willing to sacrifice the whole toe, free phalangeal bone transfer is a viable alternative. Sometimes, we have combined both the procedures to give good results.

We prefer to do the free phalangeal bone transfer before one year of age. Though we have done them even in later ages, it is believed that early surgery keeps the growth potential of the transferred toe for a longer period.



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Free phalangeal bone transfer has been done in all the fingers. Xray taken 3 years later shows that the transferred toe bone is surviving in the hand and allows the child to do useful function.



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Free Phalangeal Bone has been used to provide stability on the little finger side and a second toe transfer has been done on the thumb side. The child is able to do most of the normal activities of daily living.











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