Vascularized joint transfers. Indications and results.

Vascularized joint transfer can be beneficial in restoring joint function and maintaining growth. It is sometimes indicated in patients with painful post-traumatic arthritis, post-traumatic joint instability, and post-traumatic deformity. The best indication for this procedure is in children whose joint injury is associated with damage to growth plates in any of the digits; however, the complications associated with this procedure should not be overlooked. Extensor lag is common. This complication may be prevented during the surgical procedure by using a step-cut osteotomy to preserve the insertion of the extensor tendon, resecting the volar plate of the finger, harvesting the transferred joint with enough length to keep the extensor tendon tight, and placing the transferred joint in a maximally extended position to counteract the flexible trend of the toe joints. We believe this procedure holds promise for the future. Further improvement in surgical technique and clarification of its indications will likely enhance overall results.