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Journal of the Korean Society for Surgery of the Hand 2004;9(3):158-165.
Published online September 1, 2004.
An Analysis and Management of Major Complications of Great Toe - to - Thumb Transfer
Sang Hyun Woo, Kyung Chul Kim, Gi Jun Lee, Joo Sung Kim
족무지 전이를 이용한 무지 재건술 시 발생한 주요 합병증의 분석과 치료
우상현, 김경철, 이기준, 김주성
The authors performed 72 cases of great toe transfer for thumb defect or absence. There were 37 cases of immediate toe transfers and 35 cases of elective toe transfers. Retrospectively, we analyzed major complications after great toe transfers. Major complications were defined as vascular insufficiency demanding emergent vascular re-exploration, postoperative infection resulting in soft tissue necrosis, flap necrosis requiring secondary procedures under general or regional anesthesia, and serious problems of general conditions with life threatening changes of vital signs. The incidence of emergency re-exploration was 8.3% (6/72) and the success rate of the great toe transfer was 98.6%(71/72). There were 5 cases of serious postoperative infection. Secondary closure of the donor and recipient sites were necessary in 4 cases under general or regional anesthesia. In 2 cases, there were serious changes of vital signs. The overall incidence rate of major complications after great toe transfer was 23.6%(17/72) and there was no statistical difference on the incidence rate of the major complications according to the timing of the operation (p>0.05). To prevent major complications of the great toe transfer, pre- and postoperative check-up of general physical conditions, meticulous dissection and ligation of the vessels, complete anastomosis of the vessels, and postoperative intensive monitoring of the transferred toes were mandatory.
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