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Second-Toe Transfer for Traumatic Thumb Amputation in Children Under 5 Years: Bone and Soft-Tissue Growth

Wolff, German MD,; Posso, Carolina MD

Techniques in Hand & Upper Extremity Surgery: December 2014 - Volume 18 - Issue 4 - p 175–180
doi: 10.1097/BTH.0000000000000063

Background: Posttraumatic thumb amputations in children under 5 years are uncommon. The final clinical long-term results have been reported shortly in literature. We report our clinical experience in children under 5 years with traumatic amputation of the thumb that were reconstructed using a second-toe transfer.

Materials and Methods: There were 7 boys and 2 girls between the ages of 1 and 5 years. The follow-up was between 6 and 14 years. The average age at the time of transfer was 2.8 years, and the average follow-up was 10.7 years (range, between 6 and 14 y). The most frequent cause of amputation was avulsion (33.3%).

Results: All the transferred toes survived and achieved bone union and static 2-point discrimination was averaged at 5 mm. They acquired good prehensile pinch and grasp. All of the structures of the transferred toes showed substantial growth.

Conclusions: Second-toe transfer for traumatic amputation of the thumb continues to be one of the best choices. Children require secondary procedures less often and in some cases late functional recovery can be expected. It is a safe procedure and there are fewer complications and a better success rate.

Plastic and Reconstructive Surgery Service, University of Antioquia, Medellín, Colombia

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Carolina Posso, MD, Plastic and Reconstructive Surgery Service, University of Antioquia, Carrera 51d No. 62-29, 12345 Medellín, Colombia. E-mail:

© 2014 by Lippincott Williams & Wilkins