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Precision grip function after free toe transfer in children with hypoplastic digits.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Hand Surgery.
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
2007 (English)In: J Plast Reconstr Aesthet Surg, ISSN 1748-6815, Vol. 60, no 1, 13-23 p.Article in journal (Refereed) Published
Abstract [en]

Although toe-to-hand transfer has a defined role in the management of congenital hand deformities, it remains unclear how well children integrate the transferred digits into physiological grasping. We analysed fingertip forces in the precision grip of 13 patients when lifting a test object more than three years after free toe transfer for absent or hypoplastic digits. Clinically, most patients showed normal sensibility of transferred digits, but active motion and pinch strength were limited as compared to the normal hand. For the control of fingertip forces, two key features of the normal two-digit opposition grip were seen in all operated hands: adaptation of grip force to object weight and parallel coordination of lift and grip forces. These physiological grasping strategies developed independently of the patients' age at the time of operation, which ranged from one to 13 years. In four patients, we observed increased tangential load forces with the operated hand due to misalignments in the application of fingertips on the grasp surfaces. Such forces lead to increased grip force requirements on both fingers that may overload transferred digits with limited motor function. The need for optimal alignment of the grip axis during toe-transfer surgery is emphasised.

Place, publisher, year, edition, pages
2007. Vol. 60, no 1, 13-23 p.
Keyword [en]
Adaptation; Physiological, Adolescent, Biomechanics, Child, Child; Preschool, Female, Fingers/*abnormalities/physiopathology/surgery, Hand Deformities; Congenital/physiopathology/*surgery, Hand Strength/*physiology, Humans, Infant, Lifting, Male, Motor Activity/physiology, Thumb/physiopathology/surgery, Toes/*transplantation, Touch/physiology, Treatment Outcome
Identifiers
URN: urn:nbn:se:umu:diva-8125DOI: doi:10.1016/j.bjps.2006.04.018PubMedID: 17126262OAI: oai:DiVA.org:umu-8125DiVA: diva2:147796
Available from: 2008-01-22 Created: 2008-01-22 Last updated: 2010-06-24Bibliographically approved

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Publisher's full textPubMedhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=17126262&dopt=Citation

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Wiberg, MikaelJohansson, Roland S

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