Reconstruction of the amputated thumb using great toe transfer and dual bone lengthening technique with an Ilizarov mini-fixator

Abstract

Purpose The purpose of this study was to introduce the thumb reconstruction technique both by microsurgical reconstruction using a great toe transfer and dual bone lengthening technique with an Ilizarov mini-fixator for the fingers. Methods The great toe was transferred to the amputated thumb, followed by a bone lengthening procedure for the residual metacarpal bone to enable easy pinching. During the metacarpal bone lengthening, osteotomy was performed at two sites to shorten the period of bone fusion. Results The great toe transfer was performed successfully and metacarpal bone fusion was achieved earlier than usual by dual osteotomy technique, allowing the patients to eventually resume their previous jobs. Conclusion Our procedure reported herein, i.e., great toe transfer by microsurgery + dual osteotomy distraction lengthening, seems to serve as a useful procedure for thumb reconstruction from both cosmetic and functional improvement.