Repair of metacarpophalangeal and interphalangeal (finger) joint defects using metatarsophalangeal and interphalangeal (foot) transplantation with vascular anastamosis

To discuss the clinical effect of repairing metacarpophalangeal and interphalangeal （finger） joint defects by transferring metatarsophalangeal and interphalangeal （foot） joint with vascular anastomosis. Methods From April 1993 to November 2010, four cases of metacarpophalangeal joints, five cases of proximal interphalangeal joints and 3 cases of both joints defects were repaired by the second metatar- sophalangeal joint, PIP joint and both joints transplantation with vascular anastamosis. Results All 12 cases of grafted joints survived. Primary postoperative healing was achieved, the bone healing time was 5 to 10 weeks. The duration of postoperative follow up was 4 to 28 months, no degeneration of grafted joints was found except in 1 case with degenerative change of the metatarsal head. The postoperative range of motion （ROM） in the transferred metacarpophalangeal joint was 0° to 70°, and ROM of the PIP was 10° to 90°. Graded according to TAM/TAF scale, the outcomes of this series were excellent in 5 cases, good in 4 cases, fair in 2 cases, poor in 1 case. The overall excellent and good rate was 75%. Conclusion Repair of metacarpophalangeal and interphalangeal （finger） joint defects using metatarsophalangeal and interphalangeal （foot） transplantation with vascular anastamosis enables favorable functional recovery and joint movement that meets daily needs, providing satisfactory functional improvement of the joints. Key words: Metatarsophanlangeal joint;  Metacarpophalangeal joint;  Interphalangeal joint;  Microsurgical operation