Abstract
Vascularized toe proximal interphalangeal joint transfer has evolved as a biological
solution for posttraumatic finger joint reconstruction. Extension lag has been recognized
as a major challenge since its introduction in the 1980s. A significant advancement
came from the 2013 anatomical study that characterized two distinct patterns of toe
extensor mechanism: Type 1 (>95%) lacking obvious central slip insertion, and Type
2 (<5%) with clear central slip insertion. This understanding led to customized reconstruction
strategies based on both donor toe anatomy and recipient finger condition. Various
techniques, including centralization, direct repair, and central slip reconstruction,
have been developed. The Te technique was developed to minimize bone manipulation
while achieving similar functional outcomes to the traditional Stack technique. Current
evidence demonstrates that proper execution of central slip reconstruction can achieve
consistent functional results regardless of the technique chosen.
Keywords
vascularized toe joint transfer - proximal interphalangeal joint - central slip reconstruction
- extensor mechanism reconstruction - finger joint reconstruction