Simultaneous Stiles-Bunnell Tendon Transfer Enhances Intrinsic Function of Second-Toe Transplantations.

Claw finger is a sequela of fingers without intrinsic function. Claw toe deformity is common after toe transfer, as simultaneous intrinsic reconstruction has yet to be reported in the literature. The authors present their experience of simultaneous tendon transfer during second-toe transplantation. Seven second-toe transfers were performed in five metacarpal-like and metacarpal hands. The Stiles-Bunnell tendon transfer was incorporated into toe transfers. Toe lumbrical tendons were repaired to the flexor digitorum sublimis of the same recipient digit. The active motion values of the proximal interphalangeal joint were 61 ± 9.5 degrees and 36 ± 6.4 degrees in the middle and ring fingers, respectively. The extension lag overall was 19.9 ± 9.9 degrees. The transferred toe proximal interphalangeal joints had minimal extensor lag with the metacarpophalangeal joint in flexion position. The flexion sweep of the toe was improved by the intrinsic reconstruction. The patients were able to use the transferred toes for sophisticated daily activities. From the results seen, simultaneous intrinsic reconstruction appears to enhance the dexterity and thus function of transferred toes.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.